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Pediatric esophageal high-resolution manometry: utility of a standardized protocol and size-adjusted pressure topography parameters.
- Source :
-
The American journal of gastroenterology [Am J Gastroenterol] 2010 Feb; Vol. 105 (2), pp. 460-7. Date of Electronic Publication: 2009 Dec 01. - Publication Year :
- 2010
-
Abstract
- Objectives: Esophageal high-resolution manometry (EHRM) has evolved rapidly from a research tool to a routine investigation in adult clinical practice. This study proposes and evaluates a standardized EHRM protocol for use in pediatric clinical practice.<br />Methods: Thirty pediatric patients underwent unsedated EHRM. Indications for EHRM were dysphagia, feeding difficulty, or pre-fundoplication assessment. Two 20-channel customized water-perfused silicone catheters, with an outside diameter of 3.8 mm (MuiScientific, Ontario, CA), were used. The catheters had one distal gastric channel, five channels 0.5 cm apart for the e-sleeve, and 14 proximal channels either 1 cm (for children <5 years) or 2 cm apart (for children >5 years). Single wet swallows, multiple rapid swallows (MRS), and solid swallows were systematically studied.<br />Results: The median age was 10 years (range 6 months-15 years). The esophageal motor findings were normal peristalsis (n=15), peristaltic dysfunction (n=12), achalasia (n=3), and spasm on consumption of solid food (n=2). The distal contractile integral adjusted for esophageal length (DCIa) of patients with peristaltic dysfunction was significantly lower than that of patients without peristaltic dysfunction (P<0.001). On MRS, aperistalsis with lack of esophagogastric junction (EGJ) relaxation was observed in patients with achalasia, and aperistalsis with complete EGJ relaxation was observed in patients with severe peristaltic dysfunction. On consumption of solid food, esophageal spasm associated with bolus impaction was observed in two patients.<br />Conclusions: This study provides objective information with regard to topography pressure parameters in esophageal motility disorders of childhood while using a standardized EHRM protocol. The new DCIa variable may be useful for the assessment of patients with peristaltic dysfunction.
- Subjects :
- Adolescent
Age Factors
Catheterization
Child
Child, Preschool
Clinical Protocols
Cohort Studies
Deglutition physiology
Esophageal Sphincter, Upper physiopathology
Esophagogastric Junction physiopathology
Female
Humans
Infant
Male
Manometry instrumentation
Muscle Contraction physiology
Predictive Value of Tests
Reproducibility of Results
Esophageal Motility Disorders diagnosis
Esophageal Motility Disorders physiopathology
Manometry methods
Subjects
Details
- Language :
- English
- ISSN :
- 1572-0241
- Volume :
- 105
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The American journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 19953088
- Full Text :
- https://doi.org/10.1038/ajg.2009.656