The mononuclear cells were analyzed by FACS using macrophages marker (CD11b, CD11c, CD206, Gr-1, F4/80, Ly6C) and the cytokines Rapamycin production (TNFa, IL-6, arginase). Further, we compared with tissue macrophages number and cytokine production in the same tissue following rVVN25 treatment. To confirm the effect of tissue macrophages in liver disease of HCV Tg mice, we were injected intravenously with clodronate liposomes and examined serum ALT activity,

HCV core protein level, cell number and observed histological features. Finally, we analyzed liver disease and the function and number in tissue macrophages with Tg mice following neutralizing anti-IL-6R antibody. Results: The number of CD11b+F4/80+macrophages in selleck chemical the liver and spleen but not SVF was increased under HCV expressed condition

and especially CD11b+F4/80+CD11c-CD206+M2 macrophages remarkably increased. In addition, these M2 as well as M1 macrophages were produced TNF-a and IL-6 much higher with HCV Tg mice. rVV-N25 treatment suppressed cell number and cytokine production on macrophages in the liver and spleen. However, TNF-a production from M2 macrophages was increased in the SVF. We also showed that pathological findings in the liver have improved by depletion of macrophage even though HCV core level was not suppressed. Finally, aIL-6R antibody treatment reduced the number of macrophages and induced normal pathological findings. Conclusions: M2 macrophages contribute to the induction of chronic liver inflammation in HCV mouse models. In addition, rVV-N25 treatment induced therapeutic effect on liver tissue due to suppressed macrophage recruitment and activation. Disclosures: The following people have nothing to disclose: Kiminori Kimura, 上海皓元医药股份有限公司 Takahiro Ohtsuki, Yuko Tokunaga, Michinori Kohara Liver fibrosis progression and regression are modulated by cells of the innate immune system, especially macrophages. Macrophages can be roughly classified as classically activated

and alternatively activated (M1 and M2, respectively). While M2 have been implicated in fibrogenesis, the overall functional role of M1 and M2 in liver fibrosis remains largely unknown. M2 polarization is controlled by signaling transmitted through IL-4 and IL-13 ligation to receptors IL-4Ra1 (and IL-13Ra1). This correlates with upregulation of M2-related genes such as Stat6, Arg1, YM1 and Mrc1. We therefore aimed to define the role of IL-4Ra1 as central receptor for M2 polarization in liver fibrosis progression and spontaneous recovery. We used the mouse models of CCl4-induced (6 weeks by oral gavage) and spontaneous biliary liver fibrosis (Mdr2 KO). In the CCL4 model, IL4Ra1 expression was increased >2-fold after 6 weeks and reduced 1.5-fold 2 weeks after the last dose. In Mdr2 KO mice, IL-4Ra1 expression gradually increased until age 6-wk, and decreased thereafter.

We cultured and Gram-stained specimens obtained using a minimally invasive orogastric brush. Helicobacter

pylori status was determined by 13 C-urea breath test at 4 or more weeks post-therapy. Forty-seven subjects (7 men and 40 women, average age 42 years) were entered. The per-protocol effectiveness was 97.1% (33/34) (95% mid-P CI: 86.3, 99.9); 100% of metronidazole-resistant strains were eradicated. Side effects were mild and self-limited but contributed to nonadherence. Therapy taken for <10 days was more likely to result in eradication failure MI-503 clinical trial (p < .001). Office-based orogastric brushing was well tolerated; positive cultures were obtained in 95%. Gram staining showed H. pylori-like forms in all specimens. This pilot study supports the concept that 14-day OBMT therapy is likely to be more efficacious for H. pylori eradication (Grade A, PP basis) than a 10-day course where metronidazole resistance is suspected. If confirmed, 14 days should be recommended in populations where metronidazole selleckchem resistance is common. “
“Although Helicobacter pylori eradication is a first-line treatment of gastric MALT lymphoma, roughly 25% of patients do not respond to treatment. CD4+ FOXP3+ regulatory T (Treg) cells regulate immune responses in physiological conditions and various inflammatory conditions, including H. pylori-associated diseases.

Our goal was to determine how Treg cells affect responsiveness to H. pylori eradication therapy. We performed dual immunohistochemistry for CD4 and FOXP3 to evaluate the prevalence of FOXP3+ Treg cells in the stomach of 63 patients with MALT lymphoma and 55 patients with chronic active

gastritis. Receiver operating characteristic analysis was carried out to determine the best cut-off point in differentiating H. pylori eradication responders from nonresponders. Both the FOXP3+/CD4+ cell ratio and the absolute number of FOXP3+ cells per high-power field in MALT lymphoma were significantly greater in H. pylori eradication responders compared with nonresponders, suggesting that Treg cells function in regression mechanisms of MALT lymphomas. Cut-off points with good sensitivities MCE and specificities were obtained to predict eradication outcome. A high number of Treg cells or a high ratio of Treg cells to the total number of CD4+ T cells in gastric MALT lymphoma could predict responsiveness to eradication therapy. “
“Medline and PubMed databases were searched on epidemiology of Helicobacter pylori for the period of April 2013–March 2014. Several studies have shown that the prevalence of H. pylori is still high in most countries. In north European and North American populations, about one-third of adults are still infected, whereas in south and east Europe, South America, and Asia, the prevalence of H. pylori is often higher than 50%. H.

Therefore, clinically used recombinant retroviruses have an engineered safety modification that only allows the transfer of therapeutic nucleic acid sequences into target cells, and the infected cell cannot generate additional viral particles. Nucleic acid sequences delivered by recombinant retroviruses are integrated into the genome of the targeted cell and can be transcribed for the life of that cell, as well as all of the progeny of the transduced cell. Many retroviral vector-based strategies have been tested in preclinical models of haemophilia A, in both commercial and academic

settings. There are several reasons for this interest. First, under find more optimal conditions gene transfer using recombinant retroviruses can be extremely efficient. Second, spontaneous bleeding can be alleviated by relatively low increases in FVIII levels, where as little as 2% normal levels can be beneficial. Third, although FVIII expression is generally considered to be liver

specific, many studies have shown that different cell types are capable of synthesizing functional FVIII protein. Therefore, virtually any cell type with access to the bloodstream can be targeted for gene transfer. With respect to retroviral gene transfer, the haematopoietic stem cell (HSC) is efficiently modified and transplanted, and has, therefore, PLX4032 clinical trial been a reasonable target for haemophilia A gene therapy. Fourth, compared to repeated lifelong FVIII administration, retroviral-based gene therapy can be more economical because the number of treatment events should be limited, potentially to a single treatment. Fifth, because of the limited number of treatment events, gene therapy

can be less invasive compared to protein replacement therapy that requires multiple weekly injections. The use of recombinant retroviral vectors is unique compared to other gene transfer technologies in that the transferred genetic material is integrated into the genome of the target cell, which can provide lifelong benefits. However, this benefit may be diminished by the potential adverse consequences of retroviral gene transfer. The benefits and risks of gene transfer for haemophilia A compared to conventional intravenous replacement medchemexpress therapy have been discussed extensively [57-63]. It has been well documented that the principal concern with integrating viral-based gene therapy is the risk of insertional mutagenesis, which is the disregulation of endogenous gene functions as a result of the integrated nucleic acid sequence. The concern is based on initial retrovirus gene therapy studies where a T-cell leukaemia-like illness was found to be a serious adverse event observed in children enrolled in trials designed to treat the X-linked form of severe combined immune deficiency disease (SCID-X1) (reviewed in [64]).

Endobiliary biopsy specimens (n = 13), percutaneous liver biopsy specimens (n = 3), and surgically-resected liver specimens (n = 3) were obtained from 16 patients. Tissue sections were stained with hematoxylin–eosin (HE) and immunostained using IgG4 antibodies (The Binding Site, Birmingham, UK) with the avidin–biotin–peroxidase complex. The infiltration JQ1 supplier of IgG4-positive plasma cells was evaluated by counting the number of positive plasma cells in the four high-power fields (HPF; HE, original magnification ×400) and dividing the value by 4. The presence of ≥10 IgG4-positive cells per HPF was classified as significant infiltration. As disease controls, two prototypes

of benign and malignant biliary strictures, PSC and CCC, were compared with ISC to confirm the specificity of Selleck Dabrafenib IgG4-positive cells in histology. The resected liver specimens from patients with classic PSC and periductal infiltrating-type hilar CCC were immunostained for IgG4. Thirteen patients with classic PSC (males, n = 8; median age: 37years, range: 26–54 years), who were diagnosed according to the typical cholangiographic findings and showed progressive clinical course (accompanying ulcerative colitis in seven patients) resulting in liver failure and liver transplantation,6

and 13 patients with hilar CCC (males, n = 9; median age: 61 years, range: 57–70), who were histologically confirmed, were selected retrospectively. Serum IgG and IgG4 levels were measured in another 25 patients with hilar CCC (males, n = 14; median age: 68 years, range: 39–86) to evaluate the role in differential diagnosis. The clinical profiles MCE of 16 patients with ISC are summarized in Table 1. Of the 16 patients with ISC, 15 were male, and the mean age was 62.9 years (range: 44–80). Initial presentations included painless jaundice (n = 9, combined weight loss in two patients) and abdominal pain (n = 1). The remaining

six patients had mild abdominal discomfort without biliary pain or fever. Newly-onset diabetes mellitus was present in two patients. Neither of these patients was previously diagnosed with ulcerative colitis. The extent of bile duct involvement upon cholangiogram was as follows: both hilar and intrahepatic strictures (n = 13, including three patients with additional distal CBD strictures), hilar and distal CBD strictures (n = 1), and intrahepatic strictures alone (n = 2). The multifocal biliary tree involvement was defined when two or more different segmental branches were involved with intervening normal-looking branches. This was observed in 14 patients (Fig. 1). Marked concentric bile duct thickening with a smooth, luminal surface and preserved luminal patency was observed at the hilum in 13 patients, resembling a doughnut (Fig. 2). These thickened bile duct walls showed variable enhancement patterns.

51:1 (338:224), The three cause of lower gastrointestinal bleeding in male were inflammatory bowel disease, cancer, polyps; and in female were tumors, inflammatory bowel disease, perianal disease.The constitute ratio of male and female had no significant differences (P > 0.05). In this research, lower gastrointestinal hemorrhage deaths was 14 cases(562 cases total), the fatality rate was 2.5%.The older group was 10(older group patients was 241 cases), accounting for 4.1%; non-elderly group was 5(it’s patients was 341

cases), accounting Silmitasertib for 1.5%. There were a total of 135 cases (56%) coexisting diseases in the older group, and 21.2% in the non-elderly group respectively (P < 0.05). In this research, 362 cases have been diagnosed by colonoscopy, accounting for 64.4%.Comprehensive capsule endoscopy, Double-balloon enterscopy,

surgical instruments and means of imaging diagnosis rate was 92.3%. Conclusion: Tumors, inflammatory bowel disease, polyps were the three major causes of lower gastrointestinal hemorrhage. The age had significant differences (P < 0.05) in lower gastrointestinal hemorrhage rather than sex. Colonoscopy was the main means of diagnosis of lower gastrointestinal bleeding, comprehensive use of capsule endoscopy, colonoscopy, imaging tests and surgical means could improve the diagnosis rate of lower gastrointestinal bleeding. Key Word(s): 1. LGIH; 2. the causes; 3. mortalities; 4. inspection means; Presenting Author: XIJUN GUO Additional Authors: ZHONGXU FENG, YING SUN, SU YANG, YANQIU LIU, YOUJIA LV Corresponding Author: XIJUN GUO Affiliations: Center Hospital of Jilin City Objective: To PLX4032 evaluate clinical therapeutic effect of endoscopic sclerotherapy in treatment of acute upper gastrointestinal bleeding by Dieulafoy disease. Methods: Review and analyze clinical data of 11 patients with acute upper gastrointestinal bleeding by Dieulafoy disease after endoscopic sclerotherapy from January 1999 to December

MCE 2012. Results: 11 patients diagnosed by endoscopy for Dieulafoy disease bleeding (8 males, 3 females, age 41–69 years old), treated with endoscopic sclerotherapy, inject on 2–3 points 1–2 mm surrounding the bleeding parts. Sclerosing agent in each injection contains 5% Morrhuate Sodium (3 cases) or 1% Aethoxysklerol (3 cases) or Lauromacrogol (5 cases). All patients were to stop bleeding (the hemostatic success rate of 100 %). Conclusion: Endoscopic sclerotherapy is a safe and effective method in treatment of Dieulafoy disease bleeding. Key Word(s): 1. Dieulafoy disease; 2. Endoscopic; 3. Sclerosing agent; Presenting Author: WEIMIN MU Additional Authors: CHUANLEI LIU, SHUJUAN ZHOU Corresponding Author: WEIMIN MU Affiliations: Department of Gastroenteroloy, 222 Hospital of PLA,Number 340,Yushan Road Objective: To analysis the causes of upper gastrointestinal bleeding in patients with hepatic cirrhosis.

There are two main categories of gadolinium contrast agents used http://www.selleckchem.com/products/GDC-0449.html for hepatic imaging: extracellular agents and hepatocyte-specific agents (Table 1).8, 9 The most widely used are the extracellular gadolinium agents,

which are used for routine imaging throughout the body. These agents circulate in the vascular system, are distributed into the extracellular space, and are excreted by the kidneys. The enhancement characteristics of hepatic lesions are similar to those seen on CT. However, in some cases, the enhancement may be more conspicuous on MRI because of the increased soft tissue contrast. There are two liver-specific contrast agents: gadobenate dimeglumine (MultiHance, Bracco) and gadoxetate disodium (Eovist from Bayer HealthCare, which is also known as Primovist in Europe).8, 9 These agents are taken up by normally functioning hepatocytes and are excreted into the biliary system. Therefore, these agents may be able to differentiate tumors that have

normally functioning hepatocytes and biliary excretion from those that do not. Both gadobenate dimeglumine and gadoxetate disodium Fulvestrant are injected dynamically and are circulated and distributed in the extracellular space similarly to extracellular gadolinium agents. Therefore, similarly to the extracellular agents, imaging can be performed during the arterial and portal venous phases. However, the ability to allow delayed hepatocyte-specific imaging provides additional information. Gadobenate dimeglumine is taken up by hepatocytes and

is excreted into the biliary system by anion transport. Delayed imaging, also known as the hepatocyte phase, is usually performed at 60 to 90 minutes. Delayed imaging allows the differentiation of lesions that have normally functioning hepatocytes, which show some degree MCE of contrast uptake, from lesions without normally functioning hepatocytes, which have lower intensity in comparison with normal parenchyma. Gadoxetate disodium is transported from the extracellular space into the hepatocytes by adenosine triphosphate–dependent organic anion transporting polypeptide 1. It is subsequently excreted into the biliary canaliculi by the canalicular multispecific organic anion transporter.8 Fifty percent of this agent is excreted by the biliary system, whereas only 5% of gadobenate dimeglumine is. Therefore, there is more intense enhancement of the liver with gadoxetate disodium. In addition, the hepatocyte phase scans can be performed at only 20 minutes, and this improves efficiency. A limitation of gadoxetate disodium is that the recommended dose of 0.025 mmol/kg (0.1 mL/kg) is only one-quarter of the dose of gadobenate dimeglumine and various other extracellular agents (0.1 mmol/kg or 0.2 mL/kg). The volume of contrast administered to a 70-kg patient is one-half or 7 mL.

4%) and 216 CD (26.6%). EIMs were observed in 329 (40.6%) patients, 210 UC (35.3%) and 119 CD (55.1%) (p < 0.0001). 37 EIMs were observed before the diagnosis of IBD (11.2%), 229 EIMs after diagnosis (69.6%) and 63 (19.2%) were present at the time of diagnosis. The EIMs found were: 240 musculoskeletal (29.6%); 47 mucocutaneous (5.8%); 26 ocular (3.2%); 6 hepatobiliary (0.8%) and 10 endocrinological (1.2%). Musculoskeletal manifestations were found in 71 CD and in 169 UC (p < 0.0001). In particular, arthritis Type 1 were found in 41 CD (19%) and in 61 UC (10.2%) (p = 0.0012) and arthritis Type 2 in

25 CD (11.6%) and in 100 UC (16.8%) (p = 0.0012). Mucocutaneous 3-Methyladenine supplier manifestations were observed in 26 CD patients and in 21 UC patients (p = 0.0049). Ocular manifestations were observed in 16 CD (7.4%) and in 10 UC (1.7%), (p = 0.0093). Hepatobiliary

manifestations were found in 2 CD (0.9%) and in 4 UC (0.7%) (p = 1.0) and endocrinological in 3 CD (1.4%) and in 7 UC (1.2%), (p = 1.0). Conclusion: EIMs were significantly more frequent in CD than in UC, in particular mucocutaneous, arthritis Type 1 and uveitis. Key Word(s): 1. EIMs; 2. IBD; 3. ULCERATIVE COLITIS; 4. CROHN’S DISEASE; Presenting Author: VISHAL SHARMA Additional Authors: RANJIT SREERAMA, SURINDERS RANA, RAVI SHARMA, CHALAPATHI RAO, RITAMBHRA NADA, RAJESH GUPTA, LILESHWAR KAMAN, Venetoclax ic50 KARTAR SINGH, DEEPAKK BHASIN Corresponding Author: DEEPAKK BHASIN Affiliations: PGIMER Objective: Subset of patients with Ulcerative colitis needs immunomodulators for maintaining the disease in remission. The factors at presentation that can predict the need for immunomodulators

have not been adequately studied especially in the medchemexpress Indian population. Methods: We studied 81 patients (males 40; mean age 38.69 ± 12.90 yrs) with UC (41 prospectively & 40 retrospectively) and noted clinical presentation, duration, extra-intestinal features, extent of disease, haematological and biochemical features, and histology of the endoscopic biopsy specimens. We compared these features amongst patients who required immunomodulators and those who did not. Results: The presenting symptoms were blood in stools (100%), mucus in stools (98.8%), abdominal pain (35.8%), anorectal pain (14.8%) and extra intestinal features (4.9%). Seven patients underwent colectomy and two patients died during the study period. Immunomodulators were used in 19 patients (Azathiopurine 16, mycophenolate mofetil 2, Tacrolimus 1) and the remaining patients were in remission with 5-amino salicyclic acid (5-ASA analogues). On comparison of patients needing immunomodulators with patients maintaining remission on 5-ASA we found that the two groups were similar in age (38.68 ± 10.6 and 38.69 ± 13.6), gender (male; 47.3 and 59%), and clinical features as well as the blood investigations. But the patients who received immunomodulators were more likely to have pancolitis (47.4% versus 16.1%, p = 0.005).

For mixed-sex samples, data were extracted for the total sample and also disaggregated

by sex, if possible. If disaggregation by detainee type or sex resulted in a sample size of less than 40, that subsample was excluded. For sources reporting incidence data, the sample size, number of incident HCV cases, person-years of observation, and incidence rate were extracted. For prevalence sources, the sample size, number of anti-HCV positive participants, and prevalence were extracted. Some sources did not report all incidence or prevalence variables; STI571 price in these cases, missing variables were calculated from other reported values (i.e., numerator calculated from reported denominator and prevalence). Study design and sampling variables (geographical region; type of closed setting; prospectively or retrospectively defined cohort; random or convenience sampling; restriction of recruitment to serving inmates or new entrants; year/s of data collection; percentage of sample male and percentage injecting) were extracted in order to explore heterogeneity in reported Kinase Inhibitor Library datasheet HCV incidence and prevalence. Geographical regions were defined consistent with other recent global epidemiological reviews.[4, 5] Data analyses were conducted in Stata v. 12 (StataCorp, College Station, TX) using the metan[23]

and metareg[24] commands. Given the expected heterogeneity between studies, all meta-analyses were performed using random effects models, which account for interstudy variation. Meta-analyses of HCV incidence were undertaken for sources reporting on general population detainees and detainees with a history of IDU. Heterogeneity was assessed using the I2 statistic, which describes the percentage of variation between studies that is due to heterogeneity rather than chance.[25] Interpretation of I2 was as in Higgins et al.[25] The small number of sources of incidence MCE data prevented further stratification or meta-regression. Meta-analyses of anti-HCV prevalence were

conducted for general population detainees and detainees with a history of IDU, stratified by geographical region. Heterogeneity was assessed using the I2 statistic, as above, and also explored through meta-regression. Variables used in meta-regressions were cohort ascertainment (prospective versus retrospective); sampling (random versus convenience); detainee status at the time of recruitment (current detainees or current detainees and new entrants versus new entrants only); type of HCV antibody test undertaken (blood/sera versus saliva); mean or median age of the sample; percentage of the sample that was male; percentage of the sample with a history of IDU; and year of completion of data collection.

For mixed-sex samples, data were extracted for the total sample and also disaggregated

by sex, if possible. If disaggregation by detainee type or sex resulted in a sample size of less than 40, that subsample was excluded. For sources reporting incidence data, the sample size, number of incident HCV cases, person-years of observation, and incidence rate were extracted. For prevalence sources, the sample size, number of anti-HCV positive participants, and prevalence were extracted. Some sources did not report all incidence or prevalence variables; selleck screening library in these cases, missing variables were calculated from other reported values (i.e., numerator calculated from reported denominator and prevalence). Study design and sampling variables (geographical region; type of closed setting; prospectively or retrospectively defined cohort; random or convenience sampling; restriction of recruitment to serving inmates or new entrants; year/s of data collection; percentage of sample male and percentage injecting) were extracted in order to explore heterogeneity in reported Pritelivir molecular weight HCV incidence and prevalence. Geographical regions were defined consistent with other recent global epidemiological reviews.[4, 5] Data analyses were conducted in Stata v. 12 (StataCorp, College Station, TX) using the metan[23]

and metareg[24] commands. Given the expected heterogeneity between studies, all meta-analyses were performed using random effects models, which account for interstudy variation. Meta-analyses of HCV incidence were undertaken for sources reporting on general population detainees and detainees with a history of IDU. Heterogeneity was assessed using the I2 statistic, which describes the percentage of variation between studies that is due to heterogeneity rather than chance.[25] Interpretation of I2 was as in Higgins et al.[25] The small number of sources of incidence 上海皓元医药股份有限公司 data prevented further stratification or meta-regression. Meta-analyses of anti-HCV prevalence were

conducted for general population detainees and detainees with a history of IDU, stratified by geographical region. Heterogeneity was assessed using the I2 statistic, as above, and also explored through meta-regression. Variables used in meta-regressions were cohort ascertainment (prospective versus retrospective); sampling (random versus convenience); detainee status at the time of recruitment (current detainees or current detainees and new entrants versus new entrants only); type of HCV antibody test undertaken (blood/sera versus saliva); mean or median age of the sample; percentage of the sample that was male; percentage of the sample with a history of IDU; and year of completion of data collection.

However, the results have been inconsistent. In this study, a meta-analysis was performed to assess the association of ALDH2 and ADH1B polymorphisms Z-VAD-FMK purchase with CRC risk. Methods: Relevant studies were identified from PubMed, Web of Science and CNKI up to February 1st, 2013. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using fixed- or random-effects model. Results: A total of 11 case-control studies were selected.

Of which, 11 studies with 2893 cases and 3817 controls concerning ALDH2 Glu487Lys polymorphism, 6 studies with 1864 cases and 3502 controls concerning ADH1B polymorphism. The results indicated that there was a statistically significant link between ALDH2 polymorphism and CRC risk (Glu/Lys + Lys/Lys vs. Glu/Glu: OR = 0.87, 95%CI: 0.78–0.96, P = 0.10; Glu/Lys vs. Glu/Glu: OR = 0.87, 95%CI: 0.77–0.97, P = 0.38) Conclusion: This meta-analysis demonstrates that ALDH2 polymorphism, but not ADH1B, could significantly increase the risk of CRC in East Asians. Key Word(s): 1. ALDH2; ADH1B;; 2. Polymorphism;; 3. Colorectal cancer;; 4. Meta-analysis; Presenting Author: SHAN FAP LIEW Additional Authors: TIING LEONG ANG, ENG KIONG TEO, KWONG MING FOCK Corresponding Author: SHAN FAP LIEW Affiliations: Associate Consultant; Senior Consultant Objective: Patients with severe acute pancreatitis has high suspicion for concomitant common bile duct (CBD) stones if there is presence of either raised

serum bilirubin or dilated CBD. At presentation, CBD stones may have been passed out. Endoscopic GPCR Compound Library chemical structure retrograde cholangiopancreatography (ERCP) has been recommended for such high risk patients in the context when cross sectional imaging is negative for CBD stones. Endosonography (EUS) can obviate the need for ERCP since spontaneous passage of CBD stones may occur. Furthermore, the risk for ERCP complications is much higher than EUS. The aim of the study is to evaluate the role of EUS in avoiding diagnostic ERCP in patients

with severe acute pancreatitis with negative cross-sectional imaging but high clinical suspicion of CBD stones. Methods: From the hospital prospective EUS registry, patients with severe acute pancreatitis (as defined by Atlanta Symposium criteria) who underwent EUS were identified from March 2010 to August 2012 retrospectively. Patients with high clinical medchemexpress suspicion (i.e. raised serum bilirubin or dilated CBD or both) but negative cross-sectional imaging for CBD stone were selected. The primary outcome was the avoidance of diagnostic ERCP. Results: A total of 31 patients with severe acute pancreatitis were identified as having high suspicion for CBD stones and enrolled. EUS showed CBD stones in 12 patients (38.7%) and no CBD stone in 19 patients (61.3%). Diagnostic ERCP was avoided in 61.3% while therapeutic ERCP was performed for the rest. All cases of CBD stones identified by EUS were confirmed by ERCP during the same setting (100% specificity).