[Endoscopic manometry of Oddi's sphincter].
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Anatomy and physiology of the anorectum has been studied with manometric techniques in a normal group (n = 34) and in patients with anorectal pathology (n = 477). Authors comment manometric anomalies found in anorectal atresias, Hirschsprung's disease, constipation, neurogenic disorders (spina bifida, sacral agenesia) and the value in diagnosis, prognosis and therapeutic measures that this technique demonstrates.
22 patients presenting an "angina with normal coronarography" and 5 control subjects were subjected to a manometric exploration of the oesophagus in the basal state and under methylergometrine maleate (MEM) treatment. The MEM test is shown to be a good one for the induction of painful oesophageal dyskinesias, particularly in patients who had suffered in an inexplicable manner when that substance was administered for coronarography.
We studied rectal and anal function in 18 healthy elderly and 18 healthy young adults using intraluminal pressure transducers and a rectal balloon. Both age groups consisted of nine females and nine males. Age did not affect anal length, highest anal resting tone, anal pullthrough pressures obtained during rest and voluntary squeeze, threshold of the rectosphincteric reflex (RSR), amplitude of RSR with 60 ml rectal distension, threshold of sensation, critical volume, and rectal wall elasticity. Sex did not affect anal length, threshold of RSR, amplitude of RSR with 60 ml rectal distension, the critical volume and rectal wall elasticity. But the highest anal resting tone, anal pullthrough pressures obtained during rest and voluntary squeeze, and threshold of rectal sensation were significantly higher in the males than in the females. While aging did not affect anal and rectal function, sex did. Males achieved higher anal canal pressures. Therefore, statistical comparison between different groups of subjects is valid only if the groups are matched for sex.
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Cholangiomanometry is evaluated in 70 patients using a new technique based on needle cholangiography. In 94% of the patients the results of cholangiomanometry were in agreement with the final operative diagnosis. In two patients out of 20, common duct stones did not cause changes in the biliary pressure. In 14 patients re-operated on for postcholecystectomy pains, the increase in intrabiliary pressure due to a fentanyl dose was significantly higher than that in the control patients. Cholangiomanometry is recommended for selective use to complement needle cholangiography in biliary re-operations and in operations after biliary pancreatitis.
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