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At least 397 records · Page 22Linked to original sources
PubMed1991

[Manometry of the upper gastrointestinal tract in esophageal reflux disease].

Infusion manometry of the esophagus and the stomach after the permanent dynamic method of Winans [correction of Wynas] and Harris was carried out on 52 patients (30 women and 22 men) with hiatal hernia, volvulus of the stomach or peptic ulcer disease. Altogether 75 examinations were performed--35 preoperative and 40--postoperative. The mean preoperative pressure of the inferior esophageal sphincter was 9.1 (from 0 to 15) mmHg and the mean postoperative pressure was 18 (from 12 to 211 mmHg). The mean preoperative length of the inferior esophageal sphincter was 1.4 (from 0 to 4) cm and the mean postoperative length was 2.5 (from 1 to 6) cm. In 12 patients motor disturbances of the tubular esophagus were found: symmetric, hyperpersistaltic waves (Richter's nutcracker symptom)--in 3 patients, hypomotility--in 5 patients, diffuse esophageal spasm--in 4 patients. Esophageal manometry is a valuable noninvasive method for the functional diagnostic of the reflux disease and the motor esophageal disturbances as well as for the assessment of the postoperative function of the inferior esophageal sphincter.

Digestive System↗
PubMed1991

Preparing children for endoscopy and manometry.

Properly preparing children for endoscopy and manometry contributes to the child's ability to cope and to the nurse's efficiency and effectiveness. Therapeutic play has been documented as the ideal way to prepare children for procedures. Because of time limitations, therapeutic play is not always an alternative in the endoscopy unit. Knowledge of the different developmental stages of childhood is helpful in preparing children for procedures. The nurse's approach and preparation of the child are based on her assessment of the child's developmental age, cognitive level, past experiences and coping skills. Using her assessment of the child, the nurse establishes trust with the child and the parent prior to beginning preparation of the child. A brief overview of the abilities and needs of the infant, toddler, preschooler and school age child is presented. Suggestions are made for nursing intervention before and during the endoscopic procedure or esophageal manometry.

Child↗
PubMed1991

[Merycism or gastroesophageal reflux: value of antroduodenal manometry].

Decrease in lower esophageal sphincter (LES) pressure and frequent acid reflux were observed in 3 of 5 adult patients with rumination syndrome confirmed by antroduodenal manometry. The role of the LES in the rumination syndrome is unclear but decreased LES pressure could be a determining factor. Antroduodenal manometric studies should therefore be performed during ordinary gastroesophageal reflux in order to determine the diagnostic value of antroduodenal manometry in the rumination syndrome.

Adolescent↗
PubMed1991

[Esophageal manometry and pH-monitoring in surgical indications].

In the context of esophageal disease, the study of motility and reflux by means of manometry and pH-metry has proved rewarding in terms of prospects thanks to the physiopathologic information it is capable of providing and to the clinical applications which, in many cases, are of considerable importance. In the area of surgery, in our experience, indications for manometry include: the physiopathologic definition of a variety of diseases such as achalasia, diffuse esophageal spasm, hypertonic conditions responsible even for the formation of diverticula, esophageal reflux in the presence of a hypotonic L.E.S.. Further indications are intra- and post-operative, to verify the extension and the validity of the surgery. Surgical indications for pH-metry must include all those conditions in which esophageal reflux is not underscored by means of other investigative tools. However the omnipresence of a surgical indication in these cases is debatable. In any event this objective will be within reach only after an adequate refinement of investigative techniques and the optimal utilization of the findings obtained in the course of diagnostic exploration.

Adult↗
PubMed1991

[Intraoperative esophageal manometry].

Intraoperative manometry has been proposed as a supportive procedure during the execution of anti-reflux operations and in the surgical treatment of achalasia. This procedure is not necessary in preparing anti-reflux plasty such as Belsey or Nissen, the outcome of which depends mostly on the correct execution of the surgical technique. Utilization of intra-operative manometry provides considerable benefits during the surgical treatment of achalasia, both when executing the extra-mucous myotomy and for the correct preparation of the anti-reflux plasty according to Dor, which is associated to it. Manometric control has made it possible to define the various anatomical components that, at both the esophageal and gastric levels, constitute the area which functionally corresponds to the lower esophageal sphincter and therefore a correct execution of the myotomy. As demonstrated by the follow-up study of our surgical patients, the intraoperative manometric measurement of the strain and of the length of the anti-reflux plasty is the determining factor affecting outcome over time. The pressure is apt to decrease even 5 year after surgery; maintaining given length and strain standards when executing the plasty can prevent delayed complications, such as esophagitis from gastro-esophageal reflux.

Esophageal Achalasia↗
PubMed1991

[Computerized analysis of esophageal manometry].

Computerized analysis of esophageal manometry should consider the following objectives: a) objectivation of data acquisition; b) precision in calculating the various parameters; c) speed of analysis; d) an easy-to-read and promptly understandable graphic display of the manometric data; e) computation of new parameters capable of defining normal and pathologic function. It is with these objectives in mind that we launched our research project. Five normal subjects and 10 patients, of whom 5 presented esophageal achalasia and 5 gastroesophageal reflux disease, underwent computerized esophageal manometry and were evaluated on the basis of both traditional and innovative parameters, of our own inception. Among the various indexes tested, the "Esophageal transport" parameter, calculated as the ratio of momentum (dp*dT) over speed of propagation of the esophageal contractions, gave rise to particular interest. In our opinion, this parameter can be used as an index of the dynamic function of the organ.

Adult↗
PubMed1991

[Esophageal manometry: methods of investigation and interpretation of results].

Standard manometry is still today the method of choice for investigating motor disorders of the esophagus. Fundamental elements in executing the test are suitable equipment, an execution technique following well established protocols and the adoption of univocal criteria for interpreting the results. In fact it is essential to use low compliance pneumo-hydraulic pumps and to perform the test in distinct steps to separately evaluate the features of the sphincter and the peristaltic activity of the esophageal body. Newly introduced technology (computerized analysis) authorizes an objective analysis of the tracing and the measurement of novel parameters, making it necessary however to re-evaluate the parameters of normalcy in the asymptomatic population. The manometric features of the lower esophageal sphincter, which define its competence (mean pressure at the point of respiratory inversion, abdominal length, total length), are probably better expressed by the mean pressure of the entire LES, by the area under the curve and by the Vector Volume. As far as motility of the esophageal body is concerned, computerized manometry provides for a more precise definition of the maximum amplitude of the esophageal contractions and an objective measure of their duration.

Esophagus↗
PubMed1991

[Ambulatory manometry].

Dynamic manometry is a new technique which allows an esophageal or gastrointestinal motility recording by means of a portable recorder for a period of 24 hours. It consists of a probe with microtransducers to pick up the pressure variations of the gut lumen and a portable recorder where the pressure signals are amplified and are recorded in analogic or digital form. At the end of the examination the manometric data are transferred in the memory of a computer which afterwards provides analysis, visualization and printing of the tracing. In some system the pressure parameters are automatically calculated (mean frequency, amplitude, duration and propagation of waves, Motility Index, ect) for each period of observation (interdigestive and digestive, diurnal and nocturnal, etc). The ideal equipment, unfortunately, is not available at the moment and some of those commercially available may have particular advantages that others do not and vice versa. In this respect some economic and technical considerations should be made, ranging from their high cost to the vulnerability of some of their components, difficulty in recording the sphincter activity, unreliability incompleteness or excessive complexity of some software etc. However, the main difference of dynamic against stationary manometry consists of the fact that gut motor activity is recorded in a patient not lying in a hospital bed but during the normal life activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗
PubMed1989

[The value of ambulatory 24-hour esophageal manometry in the diagnosis of retrosternal pain of non-cardiac origin].

The clinical relevance of a system of ambulatory 24-hour oesophageal pressure and pH recording with automated data analysis was investigated in 33 unselected patients with non-cardiac chest pain. After conventional manometry with edrophonium (Tensilon) provocation, 24-hour oesophageal pH and pressure monitoring was performed. In 17 patients conventional manometry, edrophonium provocation and 24-hour pH recording revealed an oesophageal origin of the symptoms: 6 patients had oesophageal motility disorders, 3 were positive responders to edrophonium and 8 had chest pain associated with gastro-oesophageal reflux. In none of the patients who had a pain attack during prolonged oesophageal pressure recording, was a new motility disorder detected.

Chest Pain↗
PubMed1989

[Validity of ano-rectal manometry in the diagnosis of cathartic colon as a cause of chronic pseudo-obstruction of the colon. Considerations on a case].

Cathartic colon is a rare pathology which hits old people and is radiologically characterized by dolichocolon and megarectum. It is nearly sure that the unusual length of the whole colon might be the first source of the cathartic disease. Rectal ampulla dilatation (megarectum) is due to the extended use of laxatives which induce changes in smooth muscle and in the myenteric nervous plexus. The anatomo-pathological changes of the rectum have been proved so far by histological examination of local and deep biopsy; now, in our opinion, they can be shown by manometry. The authors emphasize the possibility that cathartic colon might give episodes of diarrhoea and also recurrent bowel obstructions limited to the colon and so-called "chronic pseudo-obstruction" of the colon. They describe a case of this rare pathology admitted and treated in their ward. Gastric and esophageal motility in the patient was normal as was the motility of the upper rectum. Therefore they think that changes resulted from extended use of cathartics. In both cases patients show low manometric pressure, disordered peristalsis and in particular lack of internal anal sphincter relaxation in response to high balloon distension. As the occlusive status developed in an old patient (the patient was 81 years old), the authors think that the functional disorders were absent at birth. Cathartic colon is, in the authors experience, a cause of chronic pseudo-obstruction of the colon. Rectal manometry makes it possible to avoid surgical treatment. The therapy of pseudo-occlusion, if correctly diagnosed, consists in endoscopic intubation and decompression of the colon.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

[Anorectal manometry. Practical use in a pediatric surgical clinic].

Over a series of 158 cases of anorectal manometry the authors describe the technique used in a general pediatric surgery department. Results are reported in Hirschsprung's disease specially in the neonatal period, chronic constipation, fecal incontinence after anorectal malformations and meningomyelocele, encopresis. Biofeedback was performed in 28 patients. Technique varies with the etiologies and results are reported. Anorectal manometry to be effective must be simple, reliable, safe and non invasive. The reported technique seems effective for this goal.

Anal Canal↗
PubMed1988

Comparison of radially sensitive and circumferentially sensitive microtransducer esophageal manometry probes in normal subjects.

Circumferentially sensitive microtransducer probes are commercially available for use in esophageal manometry, and may offer an advantage over radially sensitive microtransducer probes in sphincters with radial asymmetry. In order to compare performance of the two probes, we performed esophageal manometry in 30 healthy adult volunteers with both probes. In only three of 52 manometric parameters measured were differences between mean values for the two probes statistically significant. Intrasubject variability was significantly (p = less than 0.005) less with the circumferentially sensitive probe (coefficient of variation 37% vs. 53%).

Adult↗
PubMed1988

[pHmetry and manometry of the esophagus in patients with pain of the angina type and a normal angiography].

The role of gastroesophageal reflux and esophageal motility abnormalities in patients with angina-type chest pain and normal coronary angiogram is not clear. The aim of this study was: a) to assess the importance of these two disorders in the same patients, b) to study the diagnostic usefulness of provocation tests, c) to determine final outcome in these patients. Seventeen patients with angina-type chest pain and normal coronary angiograms were studied to determine the diagnostic value of esophageal manometry, postprandial esophageal pH monitoring, provocation tests (methylergometrine stimulation, acid perfusion test) and endoscopy. Baseline esophageal motility was abnormal in 10 patients. Esophageal motility disorders were nonspecific in seven patients. Eight patients had reflux. The mean lower esophageal sphincter pressure was decreased in these patients as compared with normals, and endoscopy showed a high Z line, and/or a large opening of the cardia in 7 of them. Neither conventional manometry nor postprandial esophageal pH monitoring allowed to consider the esophagus as responsible for chest pain. The methylergometrine test was positive in 4 patients (simultaneous occurrence of familiar pain and esophageal dysmotility). Baseline manometric studies did not allow to forecast the response to methylergometrine injection. The acid perfusion test was negative (no symptoms were reproduced) in all patients. After esophageal evaluation, 16 patients were followed for a mean of 26 +/- 9 months. No cardiac disorders appeared, but all patients continued to have pain, and 7 were incapable of working.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

The role of short-term multilumen duodenojejunal manometry in patients with intestinal motor dysfunction.

Short-term duodenojejunal manometry, using a multilumen perfused tube, was performed in 12 patients with symptoms of motor dysfunction, 6 patients with irritable bowel syndrome and predominant diarrhea and 6 patients with chronic constipation. Ten healthy individuals served as controls. The durations, in minutes, of the various phases of the migratory motility complex in the three groups were: phase I: 24.4 +/- 22.1, 26.9 +/- 17.3, and 27.2 +/- 18.5; phase II: 86.7 +/- 25.2, 132 +/- 93, and 73.1 +/- 40.8, and those of phase III: 6 +/- 2.5, 6.8 +/- 5, and 6.4 +/- 1.7, respectively. The differences between patients and controls were not statistically significant. Variables of contractions of phase III in the different groups were: frequency (per minute): 10.9 +/- 0.8, 10.7 +/- 0.4, and 11.3 +/- 0.4; Summation of amplitudes per minute: 205.2 +/- 55.7, 288 +/- 57.9, and 337.8 +/- 76.5; Mean amplitude (mm Hg): 19.1 +/- 4.2, 28.6 +/- 5, and 33.5 +/- 7.1, respectively. Results in the patient groups were not significantly different from controls. Short-term duodenojejunal manometry was normal in patients with irritable bowel syndrome and in those with chronic constipation.

Adult↗
PubMed1987

Clinical application of anorectal manometry.

Anal sphincter manometry provides an objective assessment of one aspect of the anorectal sphincter mechanism. It provides a far more reliable indicator of anal sphincter tone than can be achieved by digital examination. The relative contribution of the voluntary and involuntary components can be assessed, and the integrity of reflex inhibition to rectal distention can be evaluated. Anal sphincter manometry may provide direct evidence of the underlying problem as in Hirschsprung's disease or anal sphincter hypertonia. Radial cross-sectional analysis can provide identification of surgically repairable segmental defects as in the case of traumatic injury. On the other hand, the finding of a normal anal sphincter profile may serve to redirect one's investigational efforts to other components of the sphincter apparatus.

Anal Canal↗
PubMed1986

Colonic transit and anorectal manometry in chronic idiopathic constipation.

Twenty-one patients with refractory idiopathic constipation underwent studies of segmental colonic transit of radiopaque markers and anorectal manometry to determine the utility of these tests in planning therapy and in predicting subsequent clinical outcome. Colonic transit studies defined three groups: normal transit (n = 6), colonic inertia (n = 8), and distal slowing (n = 7). Normal transit was universally associated with evidence of psychosocial disturbances. During follow-ups ranging from 23.2 to 26.7 months, six of eight patients with colonic inertia failed to improve compared with only one of seven with distal slowing. Anorectal manometry was useful in excluding abnormalities of anorectal function. Segmental colonic transit of radiopaque markers is a simple and useful test in the evaluation of refractory idiopathic constipation and appears to have both prognostic and therapeutic utility in selected cases.

Adolescent↗
PubMed1986

[Endoscopic perfusion manometry of the common bile duct in the post-cholecystectomy syndrome].

In 14 cholecystectomized patients with recurrent attacks of pain endoscopic manometry of the c.b.d. was carried through after thorough exclusion of organic diseases. Two different conspicuous types of pressure behaviour became evident: In 8 pat. the pressure in the c. b. d. increased steadily during perfusion and finally triggered pain, identical to the spontaneous one according to localization and character. In 6 pat. even after prolonged perfusion no pain emerged and the c. b. d.-pressure remained unchanged. As the increase in c. b. d.-pressure connected with provocation of pain was reproducible, perfusion manometry in the c. b. d. seems to be a mean of delimitating and objectifying functional disturbances of the bile duct.

Cholecystectomy↗
PubMed1979

Manometry and histochemistry in the diagnosis of Hirschsprung's disease.

Acetylcholine esterase histochemistry and rectal manometry have been used sequentially to evaluate constipated children and to make the diagnosis of Hirschsprung's disease. When applied together, these modalities give a reliable diagnosis of Hirschsprung's disease, restricting the use of deep rectal biopsy to those patients in whom symptoms are most suggestive of Hirschsprung's disease. Acetylcholine esterase histochemistry may be more reliable than rectal manometry in the newborn and premature periods. It is hoped that the combined use of these techniques may make deep rectal biopsy obsolete except in patients with hypoganglionosis.

Acetylcholinesterase↗