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At least 613 records · Page 34Linked to original sources
PubMed2005

[Reliability index of anorectal manometry for the diagnosis of Hirschspurng disease].

UNLABELLED: The anorectal manometry (AM) and suction rectal biopsy (BS) are the main and accepted methods for diagnosis of Hirschsprung disease (HD). The reliability of these methods in newborns have been subject of controversy up to the present. MATERIAL AND METHODS: For diagnosis of HD purpose we have performed 2227 AM records in 1744 children. Initially we used a minichamber type probe joined to a close system to perform AM. From 1984 we developed a new type of 4 ways miniprobe connected to an open system which improved the reliability of the records. RESULTS: The indexes of reliability for our database have been the following: sensitivity 98%, specificity 97%, positive predictive value 85%, negative predictive value 99%, false positive 3.4% and false negative 1.8%. CONCLUSIONS: AM is a non invasive method with a high reliability, available in our hospital. It is a choice method for diagnosis of HD.

Anal Canal↗
PubMed1992

[Relationship between juxtapapillary duodenal diverticula and biliopancreatic disease--evaluation by endoscopic biliary manometry].

Endoscopic biliary manometry was performed to evaluate the motor activity of the sphincter of Oddi (SO) in 28 patients, 13 with juxtapapillary duodenal diverticula (8 with biliopancreatic disease) and 15 without diverticula (10 with biliopancreatic disease). So pressure and the rate of irregular wave pattern of phasic contraction in patients with diverticula were significantly higher than those in patients without diverticula. Especially all the patients with both diverticula and biliary stones had motor disorders of the SO. The patients with diverticula were also divided into three groups by endoscopic findings for the location of diverticular; The papilla of Vater was located close to diverticula (within about 4 cm) in group A, on the edge of diverticula in group B, in the diverticula in group C. Diverticula could have more direct effect on the motor activity of the SO in group C. Those results suggest juxtapapillary diverticula have close relationship with the motor activity of the SO and biliopancreatic disease, especially in cases which the papilla of Vater located in the diverticula. We conclude that the motor disorders of the SO might be responsible for biliopancreatic disease in patients with juxtapapillary diverticula.

Ampulla of Vater↗
PubMedDate not supplied

Relationship between bolus transit and LES-relaxation studied with concurrent impedance and manometry.

BACKGROUND/AIMS: Neuromuscular mechanisms regulating esophageal bolus transport are well studied. However, detailed data about the relationship between bolus transit and lower esophageal sphincter (LES)-relaxation during conventional motility testing are still lacking. METHODOLOGY: We performed systematic studies in 25 normal subjects, employing a catheter that integrates the two techniques impedancometry and manometry in a single instrument for simultaneous recording and analysis of the relationship between bolus transit and LES relaxation after swallowing saline or yogurt. RESULTS: 195 swallows were analyzed. LES relaxation occurred frequently later than UES relaxation. The mean latency between bolus entry into the esophagus and LES relaxation was 3.6 +0.2 sec. Two types of swallow-induced LES relaxation were observed: (a) LES relaxation preceding bolus transit (46 cases or 24%) and (b) LES relaxation occurring during bolus transit (149 cases or 76%). In the later case, during 114 (76%) cases of this deglutition, the position of the bolus was very close to the LES. CONCLUSIONS: During deglutition, LES relaxation seems to be modulated by bolus transit and occurs predominantly upon arrival of the bolus in the distal esophagus.

Adult↗
PubMed1991

[The hemodynamic effect of closed mitral recommissurotomy based on data from manometry in the heart chambers and from echocardiography].

The hemodynamic effect of operation was studied in 181 patients after closed mitral recommissurotomy on the basis of findings of intraoperative manometry in the heart chambers and echocardiography. Lower pulmonary hypertension was noted in 87.9% and that of the diastolic gradient on the mitral valve in 86.4% of patients operated upon. The echocardiographic parameters were considerably improved. The use of this operation for treatment of patients with recurrent mitral stenosis was proved to be possible.

Adult↗
PubMed1991

Normal values in anal manometry and rectal sensation: a problem of range.

Anal manometry was performed in 80 individuals, mainly healthy volunteers, 40 men and 40 women aged 20-87, mean 45 years. An open-tip perfusion system employing a catheter with 4 sideports and a terminal balloon (to be inflated with air) was used. The maximum basal pressure (MBP) showed no significant difference between men and women (68 +/- 21 and 63 +/- 19 mmHg). With respect to the maximum squeeze pressure (MSP) a significant difference was found between men and women (183 +/- 73 and 102 +/- 36 mmHg, p less than 0.001). Both MBP and MSP decreased significantly with age (both p less than 0.001). The sphincter length was larger in men than in women (4.1 +/- 0.7 and 3.5 +/- 0.5 cm, p less than 0.001) and was related to BMP (p less than 0.002). The distension reflex seemed to change with age: the threshold volume increased (p less than 0.02), the pressure drop decreased (p less than 0.03), and the recovery time increased (p less than 0.001). The pressure drop was also related to MBP (p less than 0.005). The volume of rectal perception increased with age (p less than 0.005). Ultra-slow waves were related to MBP, and were only seen when MBP greater than 70 mmHg. No relationship was to be found between parity and MBP or MSP in women. In conclusion, anal pressures and sphincter length in normal individuals have a large range and vary with age and sex. The sensitivity of the rectum to balloon inflation decreases with age. When making therapeutic decisions in patients with anorectal disorders all these factors should be taken into account.

Anal Canal↗
PubMed1991

Left ventricular maximal systolic elastance calculated by a combination of M-mode echocardiography and standard manometry.

1. A method for obtaining the end-systolic left ventricular (LV) pressure-diameter and stress-diameter relationships in man was critically analyzed. 2. Pressure-diameter and stress-diameter relationships were determined throughout the cardiac cycle by combining standard LV manometry with M-mode echocardiography. Nine adult patients with heart disease and without heart failure were studied during intracardiac catheterization under three different conditions of arterial pressure, i.e., basal (B) condition (mean +/- SD systolic pressure, 102 +/- 10 mmHg) and two stable states of arterial hypertension (HI, 121 +/- 12 mmHg; HII, 147 +/- 17 mmHg) induced by venous infusion of phenylephrine after parasympathetic autonomic blockade with 0.04 mg/kg atropine. 3. Significant reflex heart rate variation with arterial hypertension was observed (B, 115 +/- 20 bpm; HI, 103 +/- 14 bpm; HII, 101 +/- 13 bpm) in spite of the parasympathetic blockade with atropine. The linear end-systolic pressure-diameter and stress-diameter relationships ranged from 53.0 to 160.0 mmHg/cm and from 97.0 to 195.0 g/cm3, respectively. 4. The end-systolic LV pressure-diameter and stress-diameter relationship lines presented high and variable slopes. The slopes, which are indicators of myocardial contractility, are susceptible to modifications by small deviations in the measurement of the ventricular diameter or by delay in the pressure curve recording.

Adult↗
PubMed1991

Three-dimensional imaging of the anal sphincter: a new approach to anorectal manometry.

Anorectal dysfunction can be an extreme embarrassment and inconvenience to persons afflicted with the condition, disrupting their lifestyle. Evaluation of the anal sphincter and the distinction between muscular and neural etiology is essential. Three-dimensional imaging of the anal sphincter by use of anorectal manometry with an eight-port perfused catheter combined with computer analysis aids in defining anal sphincter function. The use of three-dimensional imaging is valuable to the physician in the determination of the presence of a muscular defect, the location of the defect and the appropriateness of surgical intervention to resolve the anal dysfunction.

Adult↗
PubMed1991

[Role of manometry in evaluating long-term outcomes of the surgical treatment of functional esophageal diseases].

In the years 1979-1986, 73 patients with esophageal achalasia, 110 patients with the reflux disease of esophagus and paraesophageal herniae, 17 patients with esophageal diverticles and 33 patients with duodenal ulcer were examined. The patients were examined before the intervention and controlled repeatedly after the operation in the intervals up to one month, after 3-12 months and after 2-7 years. The contribution of manometry is considered to be in giving more precision to the diagnosis and, particularly in esophagocardial achalasia, in determining a suitable operation tactics. In the reflux disease of esophagus it can contribute to the decision between a conservative and surgical therapy. The postoperative control examinations help to make an exact evaluation of the results of operation in a complex with other methods of examination.

Adolescent↗
PubMed1991

[Constipation and incontinence: significance of colonic transit time, anorectal manometry and defecography].

Constipation and fecal incontinence are frequent motives of gastroenterological consultation. An etiological diagnosis can often be suspected from the history and can be confirmed by functional testing. We here report our experience with the measurement of colonic transit time (TTC), anorectal manometry (MAR) and defecography (D). Whilst TTC was unhelpful, MAR revealed abdomino-pelvic asynchrony (anismus) in 60 constipated patients and 7 (47%) of 15 incontinent patients. Perineal descent was suspected in 25 constipated patients and confirmed by defecography, which also revealed associated static pelvic disorders. Our experience confirms the role of functional exploration in the investigation of constipation and fecal incontinence and permits a more precise therapeutic approach.

Adult↗
PubMed1991

Frequency of abnormal sphincter of Oddi manometry compared with the clinical suspicion of sphincter of Oddi dysfunction.

Patients with pancreaticobiliary pain or idiopathic pancreatitis have been classified as having definitive (type I), presumptive (type II), or possible (type III) sphincter of Oddi dysfunction (SOD) based on clinical, laboratory, and ERCP data. This study was undertaken to determine the frequency of abnormal sphincter of Oddi manometry (SOM) when patients are classified by this system. Two hundred and thirteen patients with pancreaticobiliary pain were evaluated clinically; SOM, ERCP, and ductal contrast drainage time tests were performed. For biliary types I, II, and III, the frequency of abnormal SOM was 85.7%, 55.1%, and 28.1%, respectively. Similarly, for pancreatic types I, II, and III, an elevated basal sphincter pressure occurred in 92.3%, 58.2%, and 35.1%, respectively. When patients with an abnormal basal sphincter pressure were characterized by the magnitude of the elevation, the manometric profiles were similar for types I, II, and III. These data suggest that elevated sphincter pressure occurs more frequently in type III patients than previously reported, and supports consideration of SOM when evaluating and treating type II and type III patients.

Adolescent↗
PubMed1991

[Prospects of intraoperative dynamic cholangio-manometry by tensor detectors with graphic recording of pressure function].

Intraoperative cholangio-manometry with a miniature tensor sensor and graphic recording of the results were conducted to study the function of the major duodenal papilla in 53 patients. A periodical activity of the ampulla of the papilla was revealed, which was characterized by certain values of the peak and basal pressure, and duration of contraction and relaxation periods. The numerical values and the pattern of the pressure curve differed in patients with obstructive cholecystitis, biliary pancreatitis, and a concrement incarcerated in the ampulla of the papilla. The informativeness of the study increases with the use of the glucagon test.

Adult↗
PubMed1991

[Esophageal manometry prior to and following anti-reflux surgery].

We analysed the esophageal manometry of 36 patients before, and of 25 patients 1 to 14 years (5.8 years) after, fundoplication. The results were compared with the findings in 30 asymptomatic volunteers. Fundoplication raised the mean lower esophageal sphincter pressure from 6.2 mm Hg to 14.5 mm Hg, i.e. normal values (controls 20.2 mm Hg). The shortened lower esophageal sphincter length and its intraabdominal segment were overcorrected (increase from 3.2 to 5.2 cm [controls 4.1 cm] and 1.3 to 2.6 cm [controls 2.1 cm] respectively). The rate of non-specific motility disorders after fundoplication was reduced from 61% to 28% (controls 7%). A clear relationship between the success of fundoplication and either preoperative or postoperative manometric results could not be established.

Adult↗
PubMed1991

[Comparison of methods: gastro-duodenal manometry and study of gastric emptying].

Traditionally, the stomach is regarded as two functional unit regions: 1) a proximal portion mainly involved in receptive relaxation and emptying of liquids; and 2) a distal portion that grinds, mixes and empties solids. Manometric and radioisotopic studies have been employed to construct such a physiological model. More recently, ad hoc designed studies have led to the identification of other factors that contribute to the regulation of gastric emptying. Antral, intestinal and pyloric motility, fundic tone and antropyloroduodenal coordination appear to be all involved in the regulation of gastric emptying. Nowadays, no single technique can simultaneously measure those parameters. Gastroduodenal manometry can be regarded as the most advanced technique, in studying gastrointestinal motility. Nevertheless, fundic tone, which is an important determinant of gastric emptying, cannot be concurrently recorded.

Duodenum↗
PubMed1991

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

The Authors report a review of the data gathered by manometry and pH-metry in the functional esophageal diseases. Manometric and pH-metric patterns of gastro-esophageal reflux, Barrett esophagus, diverticula, achalasia, aspecific motility disorders and non-cardiac chest pain, are analyzed. Data conditioning the choice of surgical treatment in the literature and in the authors' experience are reported in detail.

Esophageal Diseases↗
PubMed1991

[Intraoperative esophageal manometry].

The intraoperative esophageal manometry (IEM) has been used to improve results in operative management of gastroesophageal reflux and achalasia. The IEM pointed out the necessity to perform an antireflux procedure with an intraoperative sphincter pressure higher than normal, because the measured postoperative sphincter pressures were one-half the intraoperative values measured after repair. Nevertheless some authors failed to find any correlation between intraoperative and subsequent postoperative sphincter pressure measurements. The Authors, in their experience, achieved the same results with and without IEM in the surgical management of gastroesophageal reflux and achalasia. For this reason The IEM does not seem to be necessary when performing the standard Nissen or Heller procedure. It is probably useful in the surgical treatment of patients with motor disorders or sclerodermia associated with reflux and in patients who have had multiple prior operations for reflux or achalasia.

Adult↗
PubMed1991

[Intraoperative manometry during functional surgery of the esophagus].

The purpose of this investigation was to verify the suitability of intra-operative manometry in the course of functional surgery of the esophagus, especially with reference to the results obtained in terms of sphincter functionality, related to the overall changes in symptoms and pH-metry. The practice disclosed herein refers solely to the Heller-Dor operation for esophageal achalasia and to the Nissen Rossetti operation for gastro-esophageal reflux. The promising results obtained using this method to achieve a complete myotomy during Heller's operation, in our opinion testify in favor of its usefulness with this type of surgical procedure. On the contrary, for preparing a fundoplication we feel that method is of orientative value only, since there is no correspondence between the values obtained at the end of the fundoplication and those recorded 18 to 24 months after surgery. The predictive nature of the examination is thus denied.

Esophageal Achalasia↗
PubMed1991

[Esophago-gastro-intestinal manometry: study methods and potential clinical applications].

Simultaneous manometry of the esophagus and stomach and/or of the jejunum is an unconventional investigative maneuver that, for the most part, maintains features typical of a physiopathologic inquiry rather than those of clinical testing. This method contemplates the radiologically guided installation of an 8-channel probe, with measuring sites spaced 5 cm one from the other. The proximal measuring site is generally positioned at the lower esophageal sphincter (LES), while the remaining are chosen in order to attain 3 or 4 tips in the stomach and 2 or 3 tips in the duodenum (in the jejunum following stomach resection). The examination lasts approximately 6 hours during digestive rest and 2 hours after administration of a solid test meal. Hence it is possible to evaluate the functional changes at the LES with reference to the phases of the Intestinal Migrating Motor Complex, as well as the possible adverse reactions of poor gastroduodenal motility on the sphincter, both during digestive rest and after a meal. The examination, besides the obvious interest of physiopathological nature, in the Authors' experience, has made it possible to attain quite helpful functional clarifications in identifying the clinical picture of patients with complex esophageal and gastric symptoms, reduced gastric emptying, whether or not associated with mixed reflux in the esophagus. This evaluation was found to be useful both in patients with an "intact" stomach and in those who experienced surgery of the initial portion of the digestive tract.

Esophagus↗
PubMed1991

[Esophageal manometry. Normalcy and pathology].

Esophageal manometry is an established method of investigation in patients with suspected motor abnormalities. However, some degree of standardization of technique and method of analysis are still needed among different Laboratories. It is actually the gold standard for assessing the esophageal motor function but a correlation with other esophageal tests (i.e. radiology, endoscopy, pH-metry, scintigraphy) is usually required to reach a clinical diagnosis. Because of the large interindividual variability of manometric findings it is suggested that each laboratory could obtain its "own normal population". Recent evidences support that values outside the normal range may not always be associated with a functional abnormality. New physiopathological insights and widely accepted scheme of classification of manometric data are needed to improve its diagnostic usefulness.

Adolescent↗