High‐resolution manometry predicts the success of oesophageal bolus transport and identifies clinically important abnormalities not detected by conventional manometry

Neurogastroenterology and Motility - Tập 16 Số 5 - Trang 533-542 - 2004
Mark Fox1, Geoffrey Hebbard2, Patrick Janiak1, James G. Brasseur3, Sudip Kumar Ghosh3, Miriam Thumshirn1, Michael Fried1, Werner Schwizer1
1Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland
2Department of Gastroenterology Royal Melbourne Hospital Melbourne Victoria Australia
3Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA, USA

Tóm tắt

AbstractBackground and aims:  High‐resolution manometry (HRM) is a recent development in oesophageal measurement; its value in the clinical setting remains a matter of controversy. (i) We compared the accuracy with which bolus transport could be predicted from conventional manometry and HRM. (ii) The clinical value of HRM was assessed in a series of patients with endoscopy‐negative dysphagia in whom conventional investigations had been non‐diagnostic.Method:  (i) Control subjects and patients with endoscopy‐negative dysphagia underwent concurrent HRM and video‐fluoroscopy. Ninety‐five records were reviewed using HRM with spatiotemporal plot and conventional line plots of the pressure data derived from the same recording. (ii) The HRM and notes of patients with endoscopy‐negative dysphagia and abnormal bolus transport were analysed to identify additional information provided by the new technique.Results:  (i) Receiver operating characteristic analysis demonstrated that HRM predicts the presence of abnormal bolus transport more accurately than conventional manometry. (ii) HRM identified clinically important motor dysfunction not detected by manometry and radiography. These included localized disturbances of peristalsis and abnormal movement of the lower oesophageal sphincter during oesophageal spasm.Conclusion:  The HRM predicts bolus movement more accurately than conventional manometry and identifies clinically relevant oesophageal dysfunction not detected by other investigations including conventional manometry.

Từ khóa


Tài liệu tham khảo

10.1136/gut.49.1.145

10.1152/ajpgi.1991.261.4.G677

10.1152/ajpgi.1994.266.4.G525

Weinstock L, 1987, Esophageal physiology: normal and abnormal motor function, Am J Gastroenterol, 82, 399

10.1016/S0889-8553(21)00674-9

10.1007/BF02493487

10.1152/ajpgi.1993.264.3.G407

10.1111/j.1572-0241.1999.01126.x

10.2214/ajr.149.2.307

10.1016/0016-5085(94)90835-4

10.1007/PL00009572

Freidin N, 1989, Segmental high amplitude peristaltic contractions in the distal esophagus, Am J Gastroenterol, 84, 619

Traube M, 1988, ‘Segmental aperistalsis’ of the esophagus: a cause of chest pain and dysphagia, Am J Gastroenterol, 83, 1381

10.1016/0016-5085(91)90010-I

10.1053/gast.2001.22539

10.1046/j.1365-2982.1998.00103.x

Clouse RE, 2003, Development and clinical validation of a solid‐state high‐resolution pressure measurement system for simplified and consistent esophageal manometry, Am J Gastroenterol, 98, S32

10.1152/ajpgi.1991.261.4.G677

Hebbard G, 1999, High resolution perfusion manometry using an underwater reference, Neurogastroenterol Motil

10.1111/j.1572-0241.2000.03178.x

10.1148/radiology.148.3.6878708

Ghosh SK, 2002, Existence and coordination of distinct contraction waves above and below the esophageal transition zone, Neurogastroenterol Motil, 14, 582

10.1067/mge.2000.109808

Goldenberg SP, 1991, Classic and vigorous achalasia: a comparison of manometric, radiographic, and clinical findings, Gastroenterology, 101, 743, 10.1016/0016-5085(91)90534-R

10.1111/j.1572-0241.1999.00927.x

10.1159/000016967

10.1111/j.1572-0241.2000.03170.x

10.1111/j.1572-0241.1999.00847.x

10.1111/j.1572-0241.2001.05323.x

10.1016/S0042-6989(01)00147-X

Thông tin
Thông tin xuất bản

Neurogastroenterology and Motility

Tập 16 Số 5

533-542

Thông tin tác giả