OGIB accounts for approximately 5% of all gastrointestinal ACP-196 purchase bleeding events. Most OGIB events

are attributable to small bowel disease. Double-balloon enteroscopy, also known as push-and-pull enteroscopy is an endoscopic technique for visualization of the small bowel. Results: We reported a 14-years old young girl who had repeated tarry stool and severe anemia (haemoglobin: 7,46gr%). Esophagogastroduodenoscopy (EGD) and colonoscopy had been performed in other hospital, but the source of bleeding could not be identified, and the patient was transferred to our hospital. The result of both of upper and lower gastrointestinal (GI) endoscopy are normal. Thus, the source of her GI bleeding was suspected to be in the small intestine, and the patient underwent peroral double balloon enteroscopy (DBE). On DBE we found a proliferative nodular mass in the proximal of small intestine (jejenum) as a cause of gastrointestinal bleeding. Biopsy was taken and the result was mesenchymal Proteasome inhibitor tumor, suspected GIST. The patient had undergone a surgical resection tumor, and GIST was concluded by histopathology with immunohistochemical examination. Conclusion: We reported a 14-years old young girl who had repeated tarry stool and severe anemia. On DBE we found a proliferative nodular mass in the proximal of small intestine (jejenum) as a cause of gastrointestinal

bleeding. Biopsy was taken and the result was mesenchymal medchemexpress tumor, suspected GIST. The patient had undergone a surgical resection tumor, and GIST was concluded by histopathology with immunohistochemical examination. Key Word(s): 1. GIST; 2. obscure gastrointestinal bleeding; 3. small intestine; 4. and double balloon enteroscopy Presenting Author: AGUNG PRASETYO AGUNG Additional Authors: HERYANTO HERYANTO, DIDIK INDIARSO DIDIK, HERY DJAGAT P HERY, HIRLAN HIRLAN Corresponding Author: PRASETYO AGUNG Affiliations: Dr Kariadi Hospital Semarang, Dr Kariadi Hospital Semarang, Dr Kariadi Hospital Semarang, Dr Kariadi

Hospital Semarang Objective: Background: Stress related mucosal disease (SRMD) is a gastric mucosal damage as a result of physiological stress of serious illness. Gastroduodenal erosions and subepithelial bleeding usually occurs within 24 hours after the critically ill patients were admitted to the intensive care unit (ICU). The endoscopic diagnosis for majority of patients during in ICU can not be done, so diagnosis only the presence of overt gastrointestinal bleeding in patients with no previous symptoms of gastrointestinal bleeding. Based on the references, if the gastrointestinal bleeding occurs in critically ill patients, the possibility of the disease is more severe conditions. If the risk factors of SMRD have known, the prevention of bleeding in patients with a risk of SMRD who were treated in the ICU Dr Kariadi Hospital can be done. Objective : To determine risk factors SMRD in patients admitted to the ICU Dr.Kariadi Hospital.