611 PORTAL HYPERTENSIVE GASTROPATHY IN LIVER CIRRHOSIS IN CHILDREN L. Bozomitu, B.A. Stana, A.N. Azoicai, E. Moraru. 5th Pediatrics Clinic, 2nd Pediatrics Clinic, ‘Gr. T. Popa’ University of Medicine and Pharmacy, Iasi, Romania E-mail: laura.bozomitu@gmail.com Introduction: Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) syndrome are recently characterized entities that may be associated with gastrointestinal bleeding in patients with and without liver cirrhosis. Up to 65% of patients with portal hypertension of cirrhosis will develop PHG, but it can also occur in the setting of non-cirrhotic portal hypertension. In patients with portal hypertension, PHG is often associated with the presence of esophageal aand/or gastric varices Mechanisms involved in the pathogenesis of PHG have not been fully elucidated. Aim of study: To assess the existence of PHG in children with liver cirrhosis and to make correlations between PHG and clinical parameters and evolution. Material and Methods: The study group consisted of 52 patients with liver cirrhosis (mean age 13 years), diagnosed and monitored during 8 years (2004–2011) in the Pediatric Clinics of Iasi. Upper digestive endoscopy was performed in all patients. Portal hypertensive gastropathy lesions have been described according to current criteria. Presence of Helicobacter pylori was also assessed. Statistical correlations were made between aspects revealed by endoscopy and clinical and biological parameters. Results and Discussions: PHG 1st grade was found in 36 patients and 2nd grade in 16 patients. There was no appearance of acute erosive gastritis or bleeding. Appearance of ‘snake skin’ gastric mucosa, PHG characteristic lesions arised in the natural history of portal hypertension in 10 cases, in a mean period of 48 months. Helicobacter pylori has been found in 24 patients, with higher prevalence in patients with 1 grade PHG (p =0.003). Statistical correlations were made, appearance of gastric mucosa suggestive of portalhypertensive gastropathy positively correlated with the presence of ascites and low albumin levels (p = 0.011 and 0.023, respectively). Conclusions: PHG is a common finding in upper endoscopy in children with liver cirrhosis, requiring careful evaluation in order to predict disease outcome and risk of gastrointestinal bleeding. Helicobacter pylori infection needs specific treatment, carefully conducted in the context of the main disease. 612 EARLY TIPS IN PATIENTS WITH ACUTE VARICEAL BLEEDING AND THE EFFECT ON THIRTY DAY AND SIX MONTH MORTALITY RATES – A SINGLE CENTRE EXPERIENCE E. Britton, S. Mahoney, S. Powell, R. McWilliams, U. Shaikh, A. Healy, J. Evans, P. Rowlands, P. Richardson. Hepatology, Interventional Radiology, Royal Liverpool University Hospital, Liverpool, UK E-mail: edward.britton@doctors.net.uk Background and Aims: The mainstay of treatment for variceal bleeding is pharmacotherapy and endoscopic band ligation (EBL), with TIPS reserved for patients failing conventional therapy. The use of a transjugular intrahepatic portosystemic shunt (TIPS) within 72 hours for Childs Pugh C cirrhosis or Child Pugh B with active bleeding has been shown to improve survival when compared to pharmacotherapy and EBL. In light of the recent study early TIPS was adopted at the Royal Liverpool from Dec 2010. Here we report patient outcomes. Methods: All TIPS performed at the RLUH between December 2010 and August 2012 were reviewed. All patients fulfilling criteria were included. Data including time of bleed, index endoscopy, TIPS, aetiology of liver disease, Child–Pugh and MELD scores, abstinence rates, and mortality rates were obtained from the RLUH computer records and patient records. Results: Forty-seven TIPS were performed at the RLUH during the time period specified. 31 patients had early TIPS as management for variceal haemorrhage following index endoscopy, 58% (n =18) were from an ITU setting. The mean age was 50.9 and the aetiology of underlying liver disease was recorded as alcohol 68.8% (n =22), alcohol and hepatitis C 21.9% (n =7) and other 9.4% (n =3). Results are displayed in table 1.