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At least 793 records · Page 44Linked to original sources
PubMed1993

Duodenal manometry in postobstructive enteropathy in infants with a transient enterostomy.

Intestinal motility was studied in 11 children with a transient enterostomy secondary to a neonatal organic small intestine obstruction (5 total colon Hirschsprung's disease, 2 necrotizing enterocolitis, 1 intussusception, 3 ileal atresia). Eight children presented with a postobstructive enteropathy (severe grade I [5], moderate grade II [3]) and three were considered as controls (grade III). They were assigned to one of the three groups on the basis of the duration of parenteral nutrition and constant rate enteral nutrition needed and the oral feeding tolerance. Barium small intestine transit showed no persistent partial obstruction or peritoneal adhesions. The abnormal inert marker transit times were statistically correlated with the clinical groups as well as duodenal manometric abnormalities. Manometric recordings were characterised by the absence (grade I) or abnormal phase III (grade II) of the migrating motor complex and decreased motility index (grades I and II). This study confirms that this enteropathy is due to a chronic alteration in motility induced by prenatal or postnatal obstructions.

Barium Sulfate↗
PubMed2005

Under pressure: choledochal malformation manometry.

PURPOSE: The cause of choledochal (cystic or fusiform) malformation is not known. A favoured hypothesis suggests that abnormal reflux of activated pancreatic secretions via a common pancreatobiliary channel may initiate mucosal injury and mural weakness leading to bile duct dilatation, at normal intraduct pressures. However, bile duct pressures in both normal or disease states are not known in such children. METHODS: Intraoperative choledochal pressure (CP) measurements were made before any other manipulation. Bile was cultured and its amylase content measured. Biochemical liver function (bilirubin, aspartate aminotransferase, gamma-glutamyl transpeptidase, and alkaline phosphatase) was measured. Data were quoted as median (interquartile range). Statistical tests were parametric, where appropriate, and P = .05 was regarded as significant. RESULTS: Twenty-five children (age 2.5 [1.25-5.91] years) with choledochal (cystic [n = 13] and fusiform [n = 12]) malformation coming to surgery were studied. Median CP was 13 (8.5-17) mm Hg. Median bile amylase was 6722 (241-18,000) IU/L. Choledochal pressure inversely correlated with bile amylase (r = -0.60, P = .001), serum aspartate aminotransferase (r = 0.46, P = .01), and log gamma-glutamyl transpeptidase (r = 0.4, P = .04) but not with bilirubin (P = .11), alkaline phosphatase (P = .20), or age (P = .11). No difference in CP, bile amylase, or liver biochemistry could be identified between the 2 biliary phenotypes. All bile cultures were sterile. CONCLUSIONS: Increased CP is inversely related to the level of bile amylase (and hence degree of the functional common channel). This suggests that obstructive stenosis at the level of the pancreatobiliary junction (but not the ampulla) may be a causal factor in a proportion of choledochal malformations.

Alkaline Phosphatase↗
PubMed1980

Intraoperative esophageal manometry: is it valid?

Forty-five patients undergoing a Collis-Nissen antireflux operation had preoperative, several intraoperative, and postoperative distal esophageal high-pressure-zone (HPZ) measurements. In 11 patients (24%), intraoperative manipulation of the esophagus alone, prior to beginning the repair, had a major effect upon the HPZ. The final mean intraoperative HPZ pressure (21.2 mm Hg) differed significantly (p less than 0.01) from that obtained postoperatively at 1 to 3 weeks (15.2 mm Hg), 6 months (11.2 mm Hg), and 12 mm Hg), and 12 months, (12.1 mm Hg). However, there was no significant statistical correlation between the final intraoperative HPZ pressures and those obtained after 6 and 12 months. Irrespective of the final intraoperative HPZ value, no patient undergoing acid reflux testing at 6 to 12 months after operation had any gastroesophageal reflux. It is concluded that esophageal manipulation (mobilization or dilation) results in variable intraoperative Hpz values that are not reliable predictors of HPZ values obtained late postoperatively. The rationale for altering the technique of an operation simply to obtain an "ideal" intraoperative HPZ value must be seriously questioned.

Female↗
PubMed1986

Delayed rectal sensation with fecal incontinence. Successful treatment using anorectal manometry.

Retraining of the external sphincter response to rectal distention and improving the sensory threshold to balloon distention is documented as effective treatment for fecal incontinence in selected patients. Using anorectal manometric techniques, delayed conscious rectal sensation was demonstrated in 28% of 46 consecutive patients referred for fecal incontinence. In patients with delayed recognition of balloon distention, conscious rectal sensation seemed to correlate with a consistent level of internal sphincter relaxation rather than the primary stimulus of balloon distention of the rectum. Anorectal retraining techniques resulted in correction of sensory delay of 2-22 s, elimination of fecal incontinence, and improved sensory threshold in 10 of 13 patients. This previously unreported sensory abnormality represents a treatable manometric abnormality identified by anorectal motility in patients with fecal incontinence.

Adolescent↗
PubMed2003

Volume (3-dimensional) space-time reconstruction of esophageal peristaltic contraction by using simultaneous US and manometry.

BACKGROUND: Conventional 3-dimensional endoluminal US was modified to evaluate peristaltic contractions in the esophagus. METHODS: Two-dimensional US images and simultaneous intraluminal pressures were acquired during peristaltic contractions by locating the transducer at fixed positions in the esophagus in 6 normal volunteers during swallowing. Three-dimensional images were reconstructed by using a computer-based 3-dimensional algorithm with time as the x axis. RESULTS: The peristaltic contraction sequence was viewed as a 3-dimensional US image. The geometric configuration of the esophagus, the muscle thickness, and corresponding pressures were evaluated. The 3-dimensional images demonstrate 4 phases of the peristaltic contraction sequence. CONCLUSIONS: Three-dimensional time-resolved reconstruction of endoluminal US images of the esophagus and simultaneous recording of manometric data allow visualization of geometric changes and correlation with pressure changes during peristaltic contraction. Four phases of the peristaltic contraction sequence are demonstrated clearly on the 3-dimensional space-time images.

Adult↗