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At least 775 records · Page 43Linked to original sources
PubMed1978

Esophageal manometry in pregnant and nonpregnant women.

Esophageal and gastric tone was recorded in six pregnant and six nonpregnant women by means of a new technique for intraluminal pressure recordings. The recordings were performed in supine and standing positions, at rest, and during swallowing of saliva or water. It was found that the pregnant women had lower intraesophageal pressures but higher intragastric pressures compared to the nonpregnant women. In one of the pregnant women a negative pressure situation was recorded between the stomach and lower esophagus. This patient also complained of severe heartburn when she was lying down. Gastroesophageal reflux seems to be aggravated in pregnant women since esophageal peristalsis in these patients has lower wave speed and lower amplitude compared to nonpregnant women.

Adult↗
PubMed1979

Clinical significance of umbilicoportal manometry.

Ninety-six adult patients had measurements of portal pressur over 1 to 5 days via indwelling extraperitoneal umbilicoportal catheters. Liver biopsy specimens obtained during catheterization showed 50 patients to have a normal liver; the remainder had liver disease. Portal pressure averaged 16.08 +/- 2.87 (SED) cm of saline in normal patients. Ten patients, 6 with cirrhotic and 4 with normal livers, were recatheterized 1.5 days to 7 months later when they came to laparotomy. In all but one, portal pressures were decreased during anesthesia and laparotomy. Twenty additional patients undergoing cholecystectomy had portal pressures measured before and after laparotomy, and after recovery from anesthesia for 1 to 3 postoperative days. Laparotomy caused a decrease in portal pressure of 2.7 +/- 1.3 (SED) cm of saline; after recovery from anesthesia portal pressure was higher by 2.5 +/- 1.7 (SED) cm of saline. Umbilicoportal catheterization is a safe and accurate technique for studying the portal system. In the intact unanesthetized state, we consider 22 cm of saline to be the upper limit of normal for portal pressure.

Adolescent↗
PubMed1982

Endoscopic noninvasive manometry of esophageal varices: prognostic significance.

Our study attempts to establish a relation between the pressure in the esophageal varices and the clinical outcome in 18 patients in whom sclerotherapy for bleeding esophageal varices was performed. The measured pressure was compared to the endoscopic findings. Before sclerotherapy, a noninvasive manometric measurement was performed on the varices using a spheric membrane manometer fixed at the tip of an endoscope. Twelve of our 18 patients suffered repeated hemorrhage which led to death in five. We discovered a relation between the measured pressure and the outcome. Beside this, we measured the highest pressures in the largest varices. The relation that seems to exist between the pressure in the esophageal varices, the endoscopic findings, and the severity of the portal hypertension may provide new opportunities for research in this field.

Adolescent↗
PubMed1984

Rhythm abnormalities of the biliary and pancreatic sphincters: diagnosis by endoscopic manometry.

Abnormal phasic wave activity was noted in the biliary duct sphincter, pancreatic duct sphincter, or both in 43 patients. This abnormality consisted of a tachyrhythmia in 40 patients and absent phasic wave activity in 3 patients. Tachyrhythmia was encountered in patients with elevated basal sphincter pressures. In four patients with tachyrhythmia, administration of intravenous naloxone failed to modify phasic wave activity. Three patients with normal basal sphincter pressures had absent phasic wave activity. This abnormality occurred in two patients with cirrhosis and in one patient with suspected cirrhosis. In one patient with cirrhosis, administration of intravenous morphine did not induce phasic wave activity.

Adult↗
PubMed1991

Perendoscopic manometry of the distal ileum and ileocecal junction in humans.

Previous manometric studies of the ileocolonic junction were performed without assessing the precise spatial relationship between recording sensors and ileocolonic junction. In the present study, the motor activity of the ileocolonic junction was recorded using manometric sensors localized under direct colonoscopic control in 11 patients (4 men, 7 women; mean age, 55 years) referred for hematochezia with normal stool frequency. No medications were administered before and during endoscopy. A perfused catheter (OD 1.7 mm, with three side holes 4 mm apart and marked by evenly spaced black rings in the distal 6 cm) was passed through the biopsy channel of the endoscope and advanced through the ileocolonic junction and 6 cm into the ileum. The catheter was then withdrawn into the cecum by 1-cm steps, and motor activity was recorded for 4-6 minutes at each station. A single catheter taped to the endoscope continuously recorded cecal pressure. An ileocecal pressure gradient could not be identified in the majority of subjects; individual values ranged from -8 to +4 mm Hg, and gradients were maintained over the entire length of the ileum. In the distal ileum, tonic and phasic pressure waves were detected. Tonic variations were present for 70.1% of the recording time, either alone (44%) or together with phasic waves (56%). Phasic waves were present for 10.3% of the recording time and, according to their duration, were subdivided into those compatible with the rate of ileal slow waves and prolonged waves not compatible with the rate of ileal slow waves. Regular phasic waves could be either isolated or in clusters; prolonged waves were always isolated. A similar proportion of regular (27.9%) and prolonged (31.2%) phasic waves propagated aborally along the ileum or from ileum to cecum. Clusters presented an average of 8.7 +/- 0.6 peaks/min, and 44% of them propagated aborally. The manometric characteristics did not vary between the segments 5-3 cm and 2-0 cm proximal to the ileocecal junction. In conclusion, a powerful ileocecal sphincter was not detected at the human ileocecal junction, and motor activity of the distal ileum was characterized by tonic changes and rapid phasic contractions.

Adult↗
PubMed1991

Experimental evaluation of an endoscopic balloon for manometry of esophageal varices.

Measurement of pressure in esophageal varices may be performed using an endoscopic balloon technique. Improvements in this technique are described, and a complete experimental assessment of its potentials and limitations using an in vitro model consisting of an artificial esophagus containing a water-filled tube (varix) is reported. The influence of the varix diameter (3, 5, and 7 mm) and wall thickness (0.031, 0.144, and 0.256 mm) and the possible effect of the elasticity or peristalsis of the esophageal wall were investigated. Four hundred eighty pressure measurements were performed between 5 and 40 cm H2O. Linear regression analysis showed a good correlation between the pressure in the varix and that measured endoscopically (r greater than 0.9). No obvious measurement bias was found for any of the varices. Variability in pressure measurement was low in all thin-walled varices, and only in a 3-mm thick-walled varix was it found to be high [lower limit, -11.2 (1.4) cm H2O; upper limit, 6.4 (1.4) cm H2O]. Pressure measurement in a 7-mm varix was not affected by simulated peristalsis or esophageal wall elasticity. Intraobserver and interobserver reliability of measurement assessed in a series of 324 pressure measurements by three endoscopists was excellent. The authors conclude that this method may give reliable results in large and medium-sized varices and may be unaffected by peristalsis or esophageal wall elasticity. However, further assessment in vivo remains necessary.

Electronics, Medical↗
PubMed1993

Manometry of esophageal varices: comparison of an endoscopic balloon technique with needle puncture.

BACKGROUND: A noninvasive technique of pressure measurement in esophageal varices using an endoscopic balloon has been shown to be reliable in vitro. In the present study, this method was tested in vivo. METHODS: Thirty-seven pressure measurements in esophageal varices were performed in 34 patients by two independent operators (A and B) using an endoscopic balloon and compared with measurements performed by needle puncture by a third operator (C). RESULTS: Three measurements performed with the endoscopic balloon were rejected because they were noninterpretable. Measurements performed by A and B correlated well (correlation coefficient, 0.90); interobserver variability (r) was 0.88. Of 37 punctures performed for pressure measurements, 4 resulted in bleeding and 8 measurements were rejected as uninterpretable. Regression analysis showed a good correlation between the needle puncture and balloon techniques for pressure measurements performed by both operators (y = 5.3 + 1.0x, r = 0.8; y = 6.2 + 0.9x, r = 0.8), and analysis of variability showed a measurement bias of -5.3 +/- 4.1 and -4.1 +/- 3.5 cm H2O. No significant difference in variceal size measured with the endoscopic balloon or endoscopic forceps was found. CONCLUSIONS: The endoscopic balloon allows measurement of pressure in esophageal varices without hazard to the patient; in addition, it may be used to assess the varix size.

Adult↗
PubMed1995

Correlation of high-frequency esophageal ultrasonography and manometry in the study of esophageal motility.

BACKGROUND & AIMS: No studies correlate manometric measurements with morphological changes during the esophageal peristaltic sequence. The aim of this study was to develop and use a system for sonographically imaging the esophageal wall while simultaneously recording esophageal pressure changes. METHODS: An ultrasonography transducer attached to a manometric probe was used to evaluate the esophagus. RESULTS: Four sonographic phases of an esophageal peristaltic sequence were identified. The esophageal lumen was not open at rest in phase 1 (resting), increased to a maximum mean circumference of 4.90 +/- 0.57 cm in phase 2 (passive distention), and returned to a closed position in phases 3 (contraction) and 4 (relaxation). The muscle layers of the esophageal wall were baseline resting width in phase 1, decreased in width during phase 2, increased and reached maximum mean widths during phase 3, and returned to baseline widths during phase 4. The measurement of esophageal intraluminal pressure remained at a baseline resting level during phases 1 and 2, increased to a maximum mean peak of 67.95 +/- 9.18 mm Hg during phase 3, and returned to baseline during phase 4. CONCLUSIONS: A combined ultrasonography transducer/manometry probe was used to dynamically and simultaneously evaluate esophageal wall motion, muscle thickness, and esophageal pressure changes during peristalsis.

Adult↗
PubMed1991

Technical improvement for anorectal manometry in newborns.

A modification of the anorectal manometric technique has been devised to improve its accuracy in 31 low-weight newborn and premature infants. The characteristics of the probes used allowed long recording sessions without any sedation of patients. The pressure records fit well the classically accepted requisites. All recordings showed spontaneous fluctuating waves and increased mean pressure in the aboral direction. The anorectal reflex was observed in all cases. Clear reflex waves were recorded in the most caudal third of the anal canal. In this zone the recording showed more distinct features with respect to fluctuation and relaxation waves than those located in more proximal parts. The validity of this technique is unquestionable from the view of the reliability of the recordings independent of the weight, gestational age, and birth age of the infants.

Anal Canal↗