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At least 595 records · Page 33Linked to original sources
PubMed1994

Endoscopic manometry of the sphincter of Oddi and the pancreatic and biliary ducts in patients with chronic pancreatitis.

Sphincter of Oddi activity and the common bile duct (CBD) and pancreatic duct (PD) pressures were measured by means of endoscopic manometry in 15 patients (11 men and 4 women aged 18-77 (median, 40) years) with various degrees of chronic pancreatitis. Eleven of the 15 patients studied had an abnormal manometric pattern: elevated base-line pressures were seen in 8 patients, elevated duct pressures in 6 patients, abnormal peristalsis in 6 patients, and discoordination in 4 patients. There was no relation between the severity of chronic pancreatitis as shown by endoscopic retrograde pancreatography and the pancreatic function test and the manometric findings. However, a positive correlation between the sphincter of Oddi base-line pressure and the pancreatic duct pressure was found. It is concluded that manometric abnormalities are common findings in patients with chronic pancreatitis. Whether this is primary or secondary to the inflammatory process is still uncertain.

Adolescent↗
PubMed1997

Use of intrarenal needle manometry in acute renal dysfunction following renal transplantation.

Intrarenal manometry (IRM) using the Salaman fine-needle technique was routinely performed in 28 renal transplant patients in order to make the differential diagnosis of acute tubular necrosis, cyclosporin nephrotoxocity, and acute rejection. A total of 246 IRM determinations with simultaneous percutaneous renal biopsies were obtained in cases of acute renal failure following a renal transplant. Normal IRM values were 21.4 +/- 1.3 mm Hg. After collecting the clinical data, cyclosporin levels, ultrasound information, response to therapy, and renal biopsy results, we retrospectively obtained 49 IRM measurements in acute rejection, 9 in cyclosporin nephrotoxicity, and 26 in acute tubular necrosis. The values in acute rejection (41.3 +/- 9.5 mm Hg) were significantly different from the normally functioning kidneys, cyclosporin nephrotoxicity, or acute tubular necrosis. The values in cyclosporin nephrotoxicity were slightly elevated when compared to the normal or acute tubular necrosis determinations (p < 0.04) but were still significantly lower than the acute rejection. Our results suggest that IRM represents a useful technique in the approach to the acute renal dysfunction in renal transplant recipients.

Cyclosporine↗
PubMed2006

[Comparison of the endoscopic aspect of the cardia, manometry and 24 hours pH measurement in patients with chronic gastroesophageal reflux].

BACKGROUND: The endoscopic view of the gastric cardia could be related with the manometric competence of the lower esophageal sphincter (LES) and with pathological gastroesophageal reflux. AIM: To compare the endoscopic aspect of the cardia with the results from esophageal manometry and 24 h esophageal pH monitoring. MATERIALS AND METHODS: The cardia of a group of 150 patients (aged 19 to 72 years, 89 women) with gastroesophageal reflux symptoms was classified as normal or open, during upper gastrointestinal endoscopy. All subjects were subjected to a manometric study to measure LES pressure and determine LES incompetence and to a 24 h esophageal pH measurement. RESULTS: LES pressure was 14.7+/-6.2 and 8.7+/-4.2 mmHg in patients with normal and open cardia, respectvively (p <0.001). Likewise, 43 and 79% of patients with normal and open cardia had an incompetent LES, respectively (p <0.001). Pathological acid reflux was present in 43 and 71% of patients with normal or open cardia, respectively (p <0.001). CONCLUSIONS: The endoscopic appearance of the cardia can identify patients with pathological gastroesophageal reflux.

Adult↗
PubMed1993

A comparison of duplex Doppler ultrasonography and intrarenal manometry in the diagnosis of acute renal transplant rejection.

Renal transplant rejection is frequently difficult to differentiate from other causes of renal dysfunction. This study examined the use of duplex Doppler ultrasound and intrarenal manometry in a consecutive series of 73 patients who underwent renal transplantation. Altogether 327 duplex scans were analyzed and, for each, a resistive index (RI) was calculated. A raised RI predicted rejection in patients with grafts that functioned immediately, but not in those that had delayed function. A rise in intrarenal pressure ( greater than or equal to 40 mmHg) indicated the presence of rejection in both groups. However, neither test had a sensitivity of more than 71% and this was not improved by combining the results of the two tests for each patient. Although both tests have a place in transplantation, renal biopsies may still be required to confirm rejection.

Adolescent↗
PubMed1976

[Manometry, effect of pentagastrin and appearance of reflux in experimentally created hiatal hernia (author's transl)].

The importance of morphological and hormonal factors in the gastro-oesophageal junction can be evaluated, since a hiatal hernia comparable to the axial sliding hernia could be created in animal experiments. A new adequate procedure of manometry enables intraluminal pressures to be measured as a functional analysis. In 10 dogs a hiatal hernia with roentgenological reflux was performed. Pentagastrin administered intravenously could not prevent the gastro-oesophageal reflux. Pentagastrin intensified the muscle tension for only 5 minutes, but could not maintain the closing mechanism because of the altered morphological structure. After having restored the longitudinal tension of the organ by gastropexia, the terminal oesophagus has regained its closing function.

Animals↗
PubMedDate not supplied

[Esophageal manometry in gastroesophageal reflux disease. Lower esophageal sphincter incompetence or esophageal dismotility?].

BACKGROUND DATA: Hipotensive lower esophageal sphincter (HLES) has been considered the most frequent finding in patients with gastroesophageal reflux disease (GERD). Recently it has been published that esophageal dismotility (ED) has a higher prevalence in GERD. OBJECTIVE: To compare the prevalence of HLES with ED in patients with GERD. MATERIAL AND METHODS: Consecutive patients with endoscopic esophagitis grade II or higher and abnormal esophageal acid exposure time in pH-monitoring were evaluated. Stationary esophageal manometry were performed in all patients. HLES was defined by: a) LES pressure < 10 mmHg, b) LES length < 2 cm and c) LES abdominal segment < 1 cm. ED was defined by: a) presence of more than 30% of peristaltic waves with an amplitude < 30 mmHg or b) more than 10% of simultaneous waves in distal esophagus. RESULTS: Thirty-seven patients, 27 women and 10 men were evaluated. Twelve patients (32.4%) had ED, 5 (13.5%) showed HLES. Four of these 17 patients had both abnormalities. Fifteen patients (40.5%) had normal findings and in 5 (13.5%) a high LES pressure was found. CONCLUSIONS: Esophageal dismotility is the most common manometric abnormality in patients with GERD.

Adolescent↗
PubMed1999

Effect of laparoscopic antireflux operation on esophageal manometry, 24 hours pH-metry and quality of life in gastroesophageal reflux disease.

It has been suggested that laparoscopic Nissen fundoplication is an effective procedure for the treatment of gastroesophageal reflux disease (GERD). Twenty-six patients with chronic gastroesophageal reflux disease underwent laparoscopic floppy Nissen fundoplication. 24 hours pH-metry, manometry and Gastrointestinal Quality of Life Index (GIQLI) questionnaire were done preoperatively, six-month and one year after the operation. The six weeks control investigation was limited to 24 pH-metry and GIQLI interview. Adequate reflux control was obtained in all patients, with reduction in acid reflux variables at six weeks, six months as well as at one year after the operation. Preoperative reflux index and DeMeester score was significantly higher than those we found postoperatively at both time period. Preoperative lower esophageal sphincter tone and length was abnormal on average. Both parameters increased significantly at six-month and one year after the operation. GIQLI also showed characteristic changes. Compared to preoperative values we found significantly higher GIQLI at both six-month and one year following surgery. Laparoscopic Nissen fundoplication provides an excellent symptomatic and physiologic outcome in patients with esophageal reflux disease.

Data Interpretation, Statistical↗
PubMed2000

[Diagnosis using esophageal manometry and various loading tests].

Two approaches of infusion and microtransducer manipulation are available for esophageal manometry. If esophageal peristalsis and relaxation of the lower esophageal sphincter (LES) are diminished, the diagnosis of achalasia can be made. As compared with the infusion method, the microtransducer method requires no perfusion of water and has no limit on posture, allowing successful measurement in an empty esophagus. Thus this method, which allows measurement after feeding and continuous monitoring for 24 hours, seems to be more physiological than the infusion method. With this method, however, peristasis-like contractile waves and relaxation of the LES may be observed in addition to simultaneous contractile waves, even in cases of achalasia. Although methods to observe excessive reactions of the LES often involve a loading test with gastrin or mecolyl in some institutions, a loading test with cerulein is routinely used in our department. In healthy controls, administration of cerulein usually leads to decreased LES pressure, while increased LES pressure is observed in patients with achalasia (paradoxical response).

Ceruletide↗
PubMed2000

[Effect of reinforcing qi and moistening intestine oral liquid on anorectal manometry of asthenia type constipation patients].

OBJECTIVE: To study the change of anorectal manometry in asthenia type constipation patients and effect of reinforcing Qi and moistening intestine oral liquid (RQMI) on it. METHODS: The fotal of 135 cases were divided into healthy group, RQMI treated group, Maren pill (MRP) treated group and prepulside (PPS) treated group, their anal maximal voluntary squeeze pressure, rectoanal contraction reflex, rectoanal inhibitory reflex, defecation reflex, rectal volume sensory threshold and rectal maximal tolerable volume were observed. RESULTS: The rectal sensory function of patients weakened obviously and anal sphincter reactivity reduced as compared with those of healthy person (P < 0.01), and both were improved by RQMI treatment (P < 0.05). CONCLUSION: RQMI is superior to MRP and prepulside in improving anorectal dynamic abnormality in constipation patient of asthenia type.

Adult↗
PubMedDate not supplied

[Usefulness of gel lidocaine in esophageal manometry].

BACKGROUND: Esophageal manometry (EM) is a functional study performed without sedation. The insertion of a catheter through nasal passages provokes the greatest discomfort as it is being performed. OBJECTIVE: To evaluate the usefulness of lidocaine jelly to diminish discomfort patient during EM and to ease the procedure. MATERIAL AND METHODS: Ninety patients sent to EM were randomly assigned to receive lidocaine jelly at 2% (n = 45) or chlorexidine gluconate (n = 45) as a lubricant for the catheter. A solid-state catheter was employed via the pull-through technique under topic anesthesia of the hypopharynx in all cases. Patients quantified nasal pain and nausea produced by analog visual scale (AVS, 0-10 cm). The physician quantified difficulty of insertion using the same method. An independent observer kept time records from the moment of insertion of the probe through the nasal passages until the location of all sensors in the stomach (time of insertion). RESULTS: No significant differences were found between the two groups in their evaluation of nasal pain (2.8 cm lidocaine group vs. 2.6 cm chlorhexidine group), and there was no difference found in the intensity of nausea (3.3 cm vs. 3.1, respectively). Ease of the procedure was similar (2.2 cm lidocaine group vs. 1.8 cm chlorhexidine group), as well as insertion time (120 vs. 111 sec, respectively). CONCLUSIONS: Lidocaine jelly at 2% neither diminishes the discomfort provoked by the insertion of an EM catheter, nor does it make the procedure any easier.

Adolescent↗
PubMed2002

[Electrogastrography and manometry of the stomach in patients with disturbances of basic electrical rhythm].

Electrogastrography (EGG) is the only non-invasive method for investigating the myoelectric activity of the stomach. The aim was to show the relations occurring between the electromyographic and manometric recordings during the normal and abnormal EGG rhythm. A simultaneous EGG recording and manometry were performed in 20 healthy people, in 26 patients with bradygastria (group I) and 21 with tachygastria (group II). In the control group, over 90% of the EGG recording time was in the range of normogastria. After a meal, there were observed a more than twofold increase in the EGG amplitude, an improvement in the recording stability with decrease in the dysarrhythmia percent, an increase in dominant frequency (DF) and a lowering in dominant frequency instability coefficient (DFIC). In groups I and II there was shown a considerable difference in the DF range, an increase in DFIC and the number of dysarrhythmia cases, the lack of correct increase in the amplitude and lowering in the average frequency of phasic contractions and motor indices (MI). Additionally in this group there was a fall in the amplitude of contractions without MMC, and this corroborates with weak contractile activity. There was a positive correlation between the EGG amplitude changes and amplitude of phasic contractions and MI and power ratios (PR) only in the phases I and II MMC. It suggests a relationship between the EGG amplitude and changes in the stomach position and its contraction activity. The lack of correlation between the average EGG frequencies of phasic contractions and the DF and DFIC values does not allowed to observe correlation between the frequency of the phasic contractions and EGG dominant frequency.

Adult↗
PubMed1992

[Manometry indexes for evaluating esophageal function in patients with achalasia].

In 43 patients with achalasia (postoperative 18, post-dilatation 15, preoperative 10, and 10 normal people) esophageal manometry, esophageal emptying barium test and endoscopy were employed. The results showed that the esophageal emptying index EEI was 13.3 +/- 9.0 in the postoperative group, 4.7 +/- 7.6 in the post dilatation group, 50.0 +/- 17.4 in the normal group, 2.9 +/- 4.3 in the preoperative group. A linear relationship was seen between EEI and the lower esophageal barium retention area (So) (t = -5.00, P < 0.001). In patient with higher EEI and smaller So stronger esophageal emptying function was noted at swallowing. 80% of patients with less than 12 esophageal anti-reflux index (ARI) suffered from gastroesophageal reflux EEI and ARI can evaluate not only the esophageal motor functions but also the therapeutic effects of different treatment methods. The therapeutic effects are determined by esophageal peristalsis pressure and LES relaxation rate after LES is relaxed.

Adult↗
PubMed1992

[Anorectal manometry in children].

Ano-rectal manometry is a way of investigation for ano-rectal sphincters. The author overviews anatomical and physiological bases. The manometric technique and its applications in children with Hirschsprung disease or chronic constipation--with or without encopresis--is related.

Anal Canal↗
PubMed1992

[Anorectal manometry in Hirschsprung disease].

To show the absence of inhibitory reflex of the anus (R.I.A.) by ano-rectal manometry is an important sign in the diagnosis of Hirschsprung's disease. Between 1989 and 1991, a series of 199 patients was studied. The patients were divided into two groups: 0-1 month and 1 month to 50 years. Both groups were subdivided into cases with or without clinical and radiological suspicion of aganglionism. In this series, R.I.A. was absent in 88 patients and present in 111. Histologic study and follow-up confirmed the existence of aganglionism in 86 patients, hyperganglionism in 1, anal stenosis in 8, cystic fibrosis in 4 and 1 coeliac disease; the rest were megarecta to a greater or lesser degree. There was 1 false negative, signifying a percentage of error of 0.5%.

Adolescent↗
PubMed1992

[Defecography and manometry in the postoperative follow-up of patients treated with colo-anal anastomosis by the Parks technique for neoplasm stenosis of the rectum].

The Authors report 15 cases of patients with adenocarcinoma of the rectum who were treated using Park's resection. Morphofunctional parameters are evaluated 3 months after surgery using defecography and manometry before the closure of the neostoma and the reactivation of the ano-rectal canal. Opaque defecography enables the morphology and dimensions of the anal canal to be examined together with modifications to the area between the rectum and the anal canal, and the impression of the pubo-rectal sling. In conclusion these data confirm the importance of surgery, whereas the correlation between defecographic and manometric results allows the functional recovery "ad integrum" of the area to be checked.

Adenocarcinoma↗
PubMed2004

[Functional outcomes and quality of life in patients with anterior resection for rectal cancer. Does preoperative manometry predict the feasibility of a J-pouch?].

INTRODUCTION: The goal in the treatment of rectal cancer is the recovery of the disease with the best fecal continence and quality of life. The Authors compared quality of life and manometric results in patients treated with neo-adjuvant chemotherapy and rectal low anterior resection (LRA). METHODS: From January 1998 to March 2002 50 patients with advanced (T3-T4) rectal cancer underwent neo-adjuvant chemotherapy. Subsequently 41 of them underwent LRA with colon pouch (19) or without the pouch (22). After few months the quality of life was evaluated through a questionnaire. Later they underwent manometric evaluation measuring resting, squeeze and rectal compliance. RESULTS: The manometric results and the questionnaire scores agreed in 75% of patients. In detail, patients with hypotonic sphincter had a better (one could say good) quality of life if a LAR with pouch had been performed respect to the patients without pouch. CONCLUSION: Performing LAR with colon pouch after neoadjuvant chemotherapy in patients with hypotonic sphincter improves quality of life. Preoperative anorectal manometry could select patient who would benefit from pouch construction.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Analysis of the motor function of the human sphincter of Oddi by endoscopic retrograde cinecholangiography gated by manometry--a report of a case.

Although the motor function of the sphincter of Oddi (SO) has been clearly identified by endoscopic SO manometry (ESOM), the physiologic role of the phasic contractions of the SO remains unsettled in humans. The aim of this study was to correlate SO motor activity measured by ESOM with bile flow characteristics determined by simultaneously recorded endoscopic retrograde cinecholangiography. We investigated a 55-year-old female patient by means of ESOM. During the station pull-through recording, the ESOM catheter was withdrawn into the SO zone and retained there for 15 min. The pressures transmitted by the external transducers and the enlarged video picture of the choledochoduodenal junction from the X-ray fluoroscopic monitor (25 digital pictures/sec) were recorded simultaneously on the computer system with a time-correlated basis. During the analysis without taking note of the cinefluoroscopic events, we selected different manometric periods manually, such as the pressure wave of the SO phasic contraction, no SO phasic activity and the first second of the beginning of the next phasic contraction. Cumulative cinecholangiographic pictures were then constructed by the computer for each period, at a frequency of one frame/sec to create representative sum-of-pictures for each manometric period. By means of the application of manometrically gated cinecholangiography, we succeeded in demonstrating an exact time correlation between the SO systolic and diastolic movements on cinecholangiography and the pressure recording detected by ESOM in humans.

Abdominal Pain↗