T1898 The Utility of Endoscopic Ultrasound in the Evaluation of Suspected Achalasia Variants
| Autor: | Srinadh Komanduri, John E. Pandolfino, Peter J. Kahrilas, Michael Roth, Monika A. Kwiatek, Sabine Roman |
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| Rok vydání: | 2010 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty Hepatology Gastric acidity medicine.diagnostic_test business.industry Gastric operations Stomach digestive oral and skin physiology Gastroenterology Achalasia medicine.disease Gastric pressure medicine.anatomical_structure Internal medicine Esophageal sphincter Lower border Medicine business |
| Zdroj: | Gastroenterology. 138:S-602 |
| ISSN: | 0016-5085 |
| DOI: | 10.1016/s0016-5085(10)62775-8 |
| Popis: | G A A b st ra ct s of the lower border of the lower esophageal sphincter (LBLES) and measure gastric pressure 1,2,3,4 and 5 cm below the LBLES, immediately before swallow and immediately after the end of the LES relaxation, during ten swallows of water. A station pull-through pH-monitoring was performed in all but normal individuals, from 5 cm below the LBLES to the LBLES in increments of 1cm in a fasting state and 10 minutes after a standardized fatty meal. ANOVA and Student's T test were used as indicated. Results: Four patterns of gastric acidity were found: (1) acid was not detected in the stomach of 2 patients (1 RYGB and 1 SG); (2) acid was detected in the whole studied stomach, i.e., a buffered layer was not found in 6 patients (4 RYGB and 2 Nissen); PPGAP was not detected in 5 patients (2 RYGB, 2 SG, 1 Nissen); and PPGAP was noted in 3 patients (2 RYGB and 1 SG) with extensions of 1, 2 and 2 cm. Gastric pressure in the segment where PPGAP was present was not different when compared to the other segments of the stomach for measurements before swallows (p=0.97), but it was higher after swallows (p=0.02). Normal individuals showed equal pressures before (p= 0.2) and after swallow (p= 0.6). Gastric pressure in patients with PPGAP was not different to other individuals before swallows (p=0.9), but it was higher after swallows (p=0.02) in the 2 proximal cm. Conclusion: PPGAP is not a common finding in patients after gastric operations. PPGAP is associated with proximal gastric higher pressures after swallows. This finding may suggest that in patients with PPGAP food is fast impelled down from the subcardial area leaving an unbuffered acid mucosa. |
| Databáze: | OpenAIRE |
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