3912-JNeu located in the suprasellar space, with dural attachment to the tuberculum sellae and typical clinical features affecting outcome. 2 Patients most commonly present with either headache and/or visual dysfunction often differing from presentation of other meningiomas located in the anterior skull base. When they enlarge, they can affect the optic nerve and chiasm, pituitary stalk, carotid

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Intestinal ultrasound (IUS) offers a safe, noninvasive, point-of-care tool for diagnosing and monitoring disease activity in patients with inflammatory bowel disease (IBD). IUS is used widely in Europe and Canada for IBD, but it remains underutilized in the United States. Growing interest in IUS in the United States has prompted many IBD centers to train their faculty in IUS. This, however, raises questions about how to effectively use this new tool in the United States, which does not use a social medicine model like those implemented in Europe and Canada. Here, we provide a practical framework for incorporating IUS in an IBD practice in the United States, including training requirements, equipment, and protocols for implementing IUS in daily practice.

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Introduction: Choledochal cysts, typically a problem of infancy and childhood, can present in adults. Due to their malignant potential, complete excision with biliary reconstruction is the treatment of choice. Aim: To analyze the clinical, radiological characteristics, treatment offered and post-operative complications in patients with choledochal cysts treated at our institute. Methods: All patients diagnosed with choledochal cysts from 2000 to 2015 in our institute were retrospectively assessed. Demographic data, blood investigations, radiological characteristics, surgery done and post-operative complications were recorded and analyzed. Results: A total of 38 patients were diagnosed with choledochal cyst in the study period. 71% were female. Pain abdomen was the most common presenting symptom (97%), followed by jaundice (18%). Cholangitis was seen in 21% of the patients. Bilirubin was elevated in 21%, Alkaline phosphatase was elevated in 34%. 89% had Type I choledochal cysts, 8% had type IVA cysts, one patient had type IVB cyst. Anomalous pancreatico-biliary junction was identified on pre operative imaging in 4 patients. Cyst excision with reconstruction was done in patients with type I, type IV Bcholedochal cysts. Left Hepatectomy was done in 2 patients with type IVA cysts, one patient with type IVA cyst underwent left lateral segmentectomy. Post operatively wound infection was seen in 18%, bile leak was seen in 5%. Both patients with bile leak were managed conservatively. Conclusion: In choledochal cysts, typical triad of pain abdomen, jaundice and mass is uncommon. Complete excision is the treatment of choice to avoid complications like cirrhosis, hepaticolithiasis, pancreatitis, cholangitis, and cholangiocarcinoma.