The calculated median time of 7 days from negative bidirectional endoscopy was used as the standard for the overt GI bleed cohort and 30 days for the occult GI bleed cohort. A positive CE diagnostic yield was achieved in 81.8 % (9 of 11) of CEs performed within 30 days of negative bidirectional endoscopy compared

with 33.3% (8 of 24) of CEs done later in the occult GI bleed cohort. In the group of overt bleeds, 82.4% (14 of 17) of CEs done within 7 days of negative endoscopy had a positive diagnostic yield compared with 54.5% (6 of 11) of CEs done later than 7 days. 13.8% (4 of 29) of patients with negative CEs experienced recurrent GI bleed compared to 64.3% (27 of 42) with positive CEs in the combined occult and overt obscure GI bleed group. 31 % (13 of 42) of patients with positive learn more CEs in the overall obscure GI bleed cohort underwent a therapeutic intervention. Of these, buy Dinaciclib 78.6 % (11 of 14) experienced recurrent GI bleeding. Conclusion: Earlier CE in patients with either obscure occult or overt GI bleeds leads to higher CE diagnostic yield and hence appropriate therapeutic management can be offered earlier. Patients with obscure GI bleed and negative CE have a lower re-bleeding rate on follow up to 12 months suggesting in many cases, an expectant approach to management could be taken. Patients who progress to immediate therapeutic intervention post CE have a high re-bleeding rate, likely secondary

to their high risk profile and hence should be monitored more closely. Phosphatidylinositol diacylglycerol-lyase S YEAP,1 W TAM1,2 1Department of Gastroenterology, Lyell McEwin Hospital, Adelaide, South Australia, 2University of Adelaide, South Australia Background: Up to 5% of colonoscopies may be incomplete due to technical limitations such as bowel tortuosity or acute bowel angulation. Current options to visualize the remaining colon include CT colonography and enteroscope-assisted colonoscopy using either the push enteroscope or the single-balloon enteroscope. Methods: We

describe our experience in ‘salvage colonoscopy’ using combined cap application and water insufflation in patients with a current indication for colonoscopy but who had a history of previous failed or incomplete colonoscopy. Technical factors were deemed the major reasons for the incomplete colonoscopy rather than inadequate bowel preparation or patient discomfort (all procedures had been performed using propofol sedation). In the current series, a transparent cap was attached to the tip of the scope for colonoscopy. Water insufflation was achieved using a foot-controlled water pump. Caecal intubation time (CIT) and total procedure time (TPT) were recorded using the Endobase software program. Results: Four consecutive patients underwent combined cap and water-assisted colonoscopy under propofol sedation by the same endoscopist (Table). Bowel preparation was satisfactory in all cases. The caecum was intubated in all cases, and polypectomy was successfully performed. There were no adverse events.