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At least 415 records · Page 23Linked to original sources
PubMed1984

The influence of measuring catheter diameter on direct manometry in the canine sphincter of Oddi.

Sphincter of Oddi manometry was performed in three anesthetized dogs, using different measuring catheter diameters, ranging from 1.0 to 1.9 mm. No differences were seen either in sphincter of Oddi wave amplitude, frequency, and base-line pressure or in common bile duct pressure measured after cannulation during 20 min with catheters of 1.0 and 1.3 mm. However, significant disturbances of these variables were present when the measuring catheter diameter was 1.6 and 1.9 mm. It is concluded that the diameter of the recording catheter is of crucial importance in sphincter of Oddi manometry. In dogs with a body weight of 30-40 kg, the outer diameter should not exceed 1.3 mm.

Ampulla of Vater↗
PubMed1983

Jejunal manometry patterns in health, partial intestinal obstruction, and pseudoobstruction.

The purpose of this study was to determine the utility of jejunal manometry in evaluating patients having partial small intestinal obstruction or the pseudoobstruction syndrome. We studied 10 healthy volunteers, 9 patients with documented mechanical obstruction, and 3 patients with chronic intestinal pseudoobstruction during fasting and for 2 h after a 650-kcal meal. Contractile activity, especially during phase 2, was extremely variable in all individuals studied. After the meal, the most striking finding in mechanical obstruction was the regular occurrence of clustered contractions. These were defined as 3-10 regular contractions, occurring 1 per 5 s, preceded and followed by at least 1 min of absent motor activity. The associated periods of quiescent motor activity may account for the unexpectedly reduced frequency and motility index in obstructed patients compared with normal subjects after the meal. Two different contractile patterns occurred in patients with pseudoobstruction. Before and after the meal, infrequent and low-amplitude contractions occurred in 2 patients, and multiple, aborally migrating, clustered contractions occurred in the other patient with pseudoobstruction. Manometric abnormalities occur in both mechanical obstruction and pseudoobstruction. However, the technique is probably not more sensitive than radiologic procedures, and the abnormalities that are detected by manometry are not specific. Some of the same motility changes occurred in both disorders.

Adult↗
PubMed1984

Anorectal manometry in the diagnosis of Hirschsprung's disease--comparison with clinical and radiological criteria.

In 34 consecutive patients in whom the diagnosis of Hirschsprung's disease (HD) was suspected, the reliability of clinical symptoms, radiological parameters, and anorectal manometry was retrospectively and blindly evaluated by three independent investigators. In 19 patients the diagnosis of HD was histologically proved, while in the remaining 15 cases the diagnosis of idiopathic constipation was justified by persistent success of medical treatment at regular follow-up. Anorectal manometry was correctly diagnostic in all the patients who were examined. The recto and inhibitory reflex, recorded in all the patients with idiopathic constipation was absent in patients suffering from HD. Moreover, other manometric parameters, peculiar to HD were found: a significant lower anal resting pressure and pain threshold, as well as a decreased frequency of spontaneous rhythmic oscillations. The reliability of radiological and clinical data for these diagnoses appeared to be inadequate. Therefore, the diagnosis of HD can be confidently stated only on the basis of manometric investigations.

Adolescent↗
PubMed1982

Anal manometry, its applications and indications.

A manometric system is described to record the anal high-pressure zone. Anal manometry was performed in 77 individuals. It appeared that amplitude at rest is the most suitable variable to assess sphincter strength. Anal manometry is indicated in patients with chronic constipation or faecal incontinence. It may also be applied to postoperative assessment of operative procedures involving sphincter control.

Anal Canal↗
PubMed1980

Anorectal manometry for evaluating defecation disorders.

Anorectal manometry is a valuable tool in the differential diagnosis of disorders of defecation. While especially useful in differentiating between functional constipation and Hirschsprung's disease and thus reducing in many children the need for barium enema and rectal biopsy, anorectal manometry can be a practical adjunct in the diagnosis and management of patients of all ages with constipation and/or fecal soiling due to a wide range of congenital and acquired disease.

Adolescent↗
PubMed1994

Colonic transit and anorectal manometry in children with severe brain damage.

OBJECTIVE: This study was conceived to determine the physiologic abnormalities in distal gastrointestinal motility that are responsible for constipation in brain-damaged children. DESIGN: Colonic transit and anorectal manometry were evaluated in 16 children with severe brain damage and constipation (mean age +/- SD; 5.1 +/- 3.5 years) and the results were compared with findings in 15 age- and sex-matched children with functional fecal retention and normal mental development. Anorectal motility findings also were compared with those from 11 asymptomatic children. The progress of radiopaque markers, as determined by sequential plain abdominal radiographs, was used to evaluate segmental colonic transit times. RESULTS: In children with brain damage, colonic transit was prolonged at the level of left colon in 18.8% of the patients, at both left colon and rectum in 56.2%, and at rectum only in 25%. These findings differed (P < .05) from those in children with functional fecal retention wherein transit was prolonged in the left colon and rectum in 20% of the patients and the rectum only in 80%. By anorectal manometry, no significant intergroup differences were detected in anal pressures and in the anorectal motor responses to rectal distention. The rectal compliance in children with severe brain damage was similar to the asymptomatic controls, whereas children with functional fecal retention had increased rectal compliance. CONCLUSIONS: This study shows that colonic transit abnormalities in both the left colon and rectum may be responsible for constipation in children with severe brain damage.

Anal Canal↗
PubMed1994

[Effect of the menstrual cycle on the reproducibility of anorectal manometry].

The influence of the menstrual cycle on the reproducibility of anorectal manometry was investigated in 6 healthy volunteers (median age 29 years) without hormonal treatment, who were studied during the follicular and the luteal phases and during the menstruation phase. The intra- and interindividual variations were compared by calculating KENDALL's concordance coefficient. The following results were obtained (mean +/- SD): sphincter length (41 +/- 4 mm), anal pressure at rest (79 +/- 6 cm H2O) and during voluntary contraction (167 +/- 23 cm H2O), threshold volume for the anorectal reflex (12 +/- 3 ml), duration after 20 ml (24 +/- 7 seconds), after 40 ml (47 +/- 3 seconds) and variation of the rectoanal inhibitory reflex after 40 ml (25 +/- 9 cm H2O), threshold volume of rectal sensation (16 +/- 5 ml), volume of constant perception after 30 seconds (101 +/- 27 ml), maximum tolerable volume (212 +/- 18 ml) and rectal pressure during maximum tolerable volume (23 +/- 6 cm H2O). For all of the above parameters, the intra-individual variations were not higher than the inter-individual variations. We therefore conclude that the menstrual cycle does not influence the reproducibility of anorectal manometry in the healthy woman.

Adult↗
PubMed1993

[Anorectal manometry in the newborn].

Anorectal manometry was performed in 32 newborn. There were 18 preterm and 14 fullterm infants, mean ages 6.1 and 7.1 days respectively. The rectoanal inhibitory reflex (RIR) was positive in 31 of the newborn, and the relaxation waves produced by rectal distention were recorded along the anal canal and were directly correlated to intensity of the stimulus. In the remaining patient RIR was negative, due to Hirschsprung's disease, confirmed at surgery. The length of the anal canal was 10.3 +/- 2 mm. in preterm newborn infants and 14.7 +/- 2.9 mm, in fullterm (p < 0.0001). These findings suggests that presence of RIR is independent of the weight, gestational age and birth age of the infant, and that anal canal length is correlated with the weight of the infant. We conclude that anorectal manometry, in the neonatal period, is a simple, reliable and safe method to test anorectal functionality, including the study of Hirschsprung's disease.

Female↗
PubMed1993

Esophageal motility in low-grade reflux esophagitis, evaluated by stationary and 24-hour ambulatory manometry.

Whereas previous studies have unequivocally shown that esophageal motility is abnormal in patients with severe reflux esophagitis, the results of motility testing in patients with low-grade esophagitis are inconsistent. We studied 27 patients with Savary grade I and II esophagitis and 24 healthy controls matched for age and sex. Both underwent conventional manometry and 24-h ambulatory pH and pressure monitoring. Esophageal acid exposure was greater in patients than controls. The mean lower esophageal sphincter pressure was significantly lower in esophagitis patients [1.46 +/- 0.09 vs. 1.79 +/- 0.11 kPa (10.98 +/- 0.68 vs. 13.46 +/- 0.83 mm Hg)]. The total number of contractions recorded in the 24-h period was not different in the patient group (2168 +/- 108.4 vs. 2033 +/- 130.5), but esophagitis patients had an increased number of nontransmitted contractions (968 +/- 39.4 vs. 773 +/- 50.2, p < 0.01). A tendency toward a decreased prevalence of peristaltic contractions just failed to reach statistical significance (p = 0.07). Both conventional manometry and 24-h monitoring showed no significant difference in peristaltic amplitude between the two groups. Differences in contraction duration (2.02 +/- 0.08 vs. 2.39 +/- 0.12 s, p < 0.01) and velocity of the peristaltic wave (3.65 +/- 0.10 vs. 4.63 +/- 0.13 cm/s, p < 0.01) were only detected by 24-h monitoring. The findings made in this study do not support the concept that impaired esophageal peristalsis is a major factor in the pathogenesis of low-grade esophagitis.

Esophageal Motility Disorders↗
PubMedDate not supplied

[Anorectal manometry. Experience of 5 years].

Anorectal manometry is a non invasive, safe and useful procedure for exploring anorectal function in several disease. The anorectal studies made in our service the last five years in children, were reviewed. There were made 234 procedures in patients 21 year old or less 93.25% of the studies could be finished and 72.64% of the patients were from other hospitals or centers. The age average was 5.62 +/- 4.72 years and the main indication was constipation (78.20%). We didn't find any statistical difference in the manometrical findings of the internal anal sphincter between the patients with only constipation, only encopresis, constipation plus encopresis and normal values. The main manometrical diagnostic in the constipated patient without Hirschsprung disease was "Normal Study" even though between 30 and 55% of the studies showed "inspecific motor dysfunction". The patients with anorectal malformations had a main internal and pressure statistically lower (Z = 3.29 p = 0.03) and "Non concluyent Study" percentage higher (Z03.44 p = 0.02) than the constipated ones. The main external anal pressure was not different between groups. In 43 patients the manometrical study showed "Suggestive of Hirschsprung Disease". We recovered the histological reports in 55.88% with aganglionosis in the 91.66%. There were no statistical differences in the other manometrical parameters. Our finding agree with the ones reported in the specialized literature and support the anorectal manometry as an useful tool for exploring the anal sphincter integrity in anorectal malformations.

Adolescent↗
PubMed1995

Effect of endoscopic sphincterotomy on sphincter of Oddi manometry results in patients with or without papillary stenosis.

Patients with fibrotic papillary stenosis (PS) are at high risk for sphincter of Oddi-re-stenosis after endoscopic sphincterotomy (ES). Therefore, a prospective trial was conducted to assess the acute and long-term effects of ES on sphincter of Oddi motor function in patients with papillary stenosis. The immediate effects of ES were studies by endoscopic manometry in 12 patients with PS, and in 15 patients with common bile duct stones (CBDS, control group). Furthermore, after a median follow-up of 15 months, 11 from those 12 patients with papillary stenosis were reinvestigated with ERCP and manometry. Complete ES (defined by a common bile duct pressure and a basal sphincter of Oddi-pressure (BSOP) < 5 mm Hg) was achieved in 13/15 CBDS-patients, but only in 3/12 patients with PS (p<0.01), although sphincterotomy was extended to the maximal length as judged endoscopically. Four patients with PS had a residual BSOP > 20 mm Hg. However, all patients with PS became symptom-free immediately after ES. The phasic sphincter motility was not affected significantly different in both groups of patients (p = 0.25). Those patients with a residual BSOP > 20 mm Hg after ES developed sphincter of Oddi-re-stenosis during the follow-up (3 patients) or revealed re-stenosis at the control examination after follow-up (1 patient). After the follow-up manometrically defined complete sphincterotomy was furtheron demonstrable in only 2/11 patients with papillary stenosis. In conclusion, ES revealed a decreased efficacy to eliminate the sphincter of Oddi motor function in a substantial number of patients with papillary stenosis. This may explain the remarkably high rate of sphincter of Oddi-re-stenosis after sphincterotomy in these patients.

Adult↗
PubMedDate not supplied

[Anorectal manometry in hemorrhoidal disease].

Manometry is an important approach to anorectal function. In the haemorrhoids the evaluation of the anal resting tone, of the squeeze and of the sphincterial length is very useful to realize the best surgical treatment. Anorectal manometry is neither invasive nor expensive; it can be ready repeated and the results are reproducible. This examination must be considerated as essential part of the diagnostic routine of the anorectal diseases.

Anal Canal↗
PubMed1977

[Manometry and gastro-esophageal closure mechanism. An attempt at evaluation (author's transl)].

The registration of resting pressures and motility activity has considerably increased our knowledge of the normal functioning of the esophagus. We have not jet solved all the methodological problems of manometry; however perfusion manometry, which is used today, has enabled us to make an exact cassification of functional disorders and adequate therapy. An understanding of the methodological problems involved is necessary for the correct use of the manometric method and the correct interpretation of its results. This precondition has not always been observed, especially in discussion of the gastro-esophageal closure mechanism, and has thu given rie to much confusion. An attempt at a critical evaluation should be the basis for future discussion.

Cardia↗
PubMed1998

The role of sphincter of Oddi manometry in the diagnosis and therapy of pancreatic disease.

Endoscopic manometry of the sphincter of Oddi (SO) is now an accepted technique in the diagnosis and therapy of biliary disease. Its role in the evaluation of pancreatic sphincter function for pancreatic diseases, however, is evolving. There are now preliminary data to suggest that pancreatic SO manometry may identify a subgroup of patients with pancreatic sphincter dysfunction that may benefit from endoscopic therapy. Further prospective clinical trials are sorely needed to evaluate the response of endoscopic therapy based on pancreatic SO basal pressure or pancreatic ductal pressure.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1997

[Value of anorectal manometry in assessment of constipation in childhood].

We studied retrospectively 210 anorectal manometries of constipated children. Of the 87 patients with an anal fissure or a functional constipation, 83 had normal sphincter relaxation. All of the 23 patients with Hirschsprung's disease lacked the sphincter relaxation, as well as 22 of the patients with a dysganglionosis. Eleven patients with innervation defects showed pathologic sphincter contractions. Anorectal manometry is a valuable tool to differentiate between innervation defects and constipation of other etiologies.

Adolescent↗
PubMedDate not supplied

Endoscopic biliary manometry in cholecystectomized patients with and without choledocholithiasis.

BACKGROUND/AIMS: Direct study of the function of the sphincter of Oddi became possible recently with the advent of endoscopic manometry. A dysfunction of the bilio-pancreatic sphincter apparatus has been implicated in some bilio-pancreatic disorders. The purpose of this study was to examine the relation between dysfunction of the sphincter of Oddi and the formation of common bile duct stones. METHODOLOGY: Endoscopic biliary manometry was performed on 45 cholecystectomized patients. Endoscopic retrograde cholangiography showed choledocholithiasis in 26 patients while 19 patients were free of common bile duct stones. Nine healthy subjects served as controls. RESULTS: Manometric investigation showed a significant increase in the percentage of retrograde phasic contractions of the sphincter of Oddi (SO) in patients with choledocholithiasis compared to the control group (p < 0.05). Also, a significantly higher frequency of SO phasic contractions was found in the group of patients with choledocholithiasis when compared to the cholecystectomized group without common bile duct stones (p < 0.05), but there was no difference when compared with the control group. Markedly increased SO basal pressure was found in 5 patients with choledocholithiasis as well as in one cholecystectomized patient without choledocholithiasis (greater than x + 3SD). However, the SO basal pressure, phasic SO pressure, amplitude and duration of the phasic contractions as well as the choledochal pressure did not differ significantly between the groups. CONCLUSIONS: This study demonstrates manometric abnormalities in the SO of patients with choledocholithiasis which suggests that SO dysfunction and pathophysiological mechanisms are related to the formation of common bile duct stones.

Biliary Tract↗
PubMed1998

Study of esophageal function by standard esophageal manometry in 72 healthy volunteers. Proposal for national reference values. Spanish Group for the Study of Digestive Motility.

AIM: A multicenter study was carried out to establish the normal values of different esophageal motility variables in a large group of healthy volunteers to be considered as national reference values. PARTICIPANTS: Standard esophageal manometry was performed in 72 healthy individuals (38 males/34 females) of a mean age of 43 years (range: 18-73 years). Equipment and methodology were standardized by the participating centers prior to initiation of the study. Lower and upper esophageal sphincter characteristics and the features of the esophageal motility waves were analyzed. RESULTS: The amplitude and length of the peristaltic waves of the esophageal body increased distally, while the speed of proximal progression was lower than that of the distal speed. The presence of a reduced, but significant number of double peaked simultaneous, spontaneous and non-transmitted waves were of note. Upper and lower esophageal sphincter motility as well as relaxation capacity and pharyngeal contraction were defined. CONCLUSIONS: Given the characteristics of the population analyzed and the statistical consistence of the results obtained, the values herein reported may be considered as national reference values for esophageal motility studies carried out by standard esophageal manometry.

Adolescent↗
PubMed1990

Oesophageal manometry and pH recording does not predict the bad results of Nissen fundoplication.

A prospective study of the value of preoperative oesophageal manometry in selecting patients for gastro-oesophageal reflux surgery has been performed. One hundred and twenty-six consecutive patients had a floppy Nissen fundoplication with a median follow-up period of 48 months (range 21-96 months). Reflux was controlled in 116 patients (92.1 per cent). One hundred and five patients (83.3 per cent) had a clinically satisfactory result (Visick grades 1 and 2). Poor results were largely due to recurrent reflux, technical failure or the irritable bowel syndrome. An unsatisfactory result was not more likely in those with upright reflux, an oesophageal motility disorder or a competent cardia as defined by manometry. Preoperative oesophageal studies, other than those required to make an accurate diagnosis, were found to have no value in deciding the suitability of patients for surgical correction of gastro-oesophageal reflux.

Adult↗