Antroduodenal manometry: experience from a tertiary care center.

BACKGROUND: Though antroduodenal manometry (ADM) is an important research tool, experience on its clinical utility is scanty. METHODS: All ADM performed as a clinical service, using an 8-channel water perfusion system were retrospectively analyzed. Impact on clinical management was classified as: (1) new diagnosis made, (2) change in management (new drug, decision regarding surgical treatment), (3) further special investigation done, (4) referral to another specialty. RESULTS: ADM was successful in 32/33 (97%) patients (age 30 years [range 8-71]); 6 patients were < 12 years old. Clinical impression before ADM was: chronic intestinal pseudo-obstruction (CIPO) in 16 (50%), suspected gastroparesis in 11 (34.3%), dyspepsia in 5 (15.6%). Consequent to ADM in patients with CIPO, a new diagnosis was made in two (intestinal neuronal dysplasia and celiac disease), new drugs were started in five, surgery was performed in three and specific referral was sought in three. ADM confirmed gastroparesis in 9 of 11 patients. A new diagnosis was made in three patients, new drugs were started in three, and three were referred. In five dyspeptic patients, ADM was normal and no therapy was suggested. Overall, eleven patients with CIPO and four with gastroparesis benefited after ADM. CONCLUSION: ADM was found useful in CIPO and gastroparesis, helped in decision making regarding surgery; however in nonspecific indications its utility was limited.

Estudio del vaciamiento gástrico de diferentes líquidos mediante ultrasonografía / Gastric emptying of different liquid test meals measured by real time ultrasonic imaging

Estudiamos el vaciamiento gástrico de líquidos en 80 sujetos voluntarios sanos del sexo masculino (edad promedio 19.9 ñ 1.6 años) mediante ultrasonografía de tiempo real. Realizamos múltiples cortes del antro a intervalos regulares (15-30 minutos) hasta completar el vaciamiento gástrico después de la ingestión a 500 ml de 8 diferentes dietas líquidas ensayadas: salina isotónica, glucosada al 50%, glucosada al 5%, proteínas 40 g, proteínas 20 g, grasas 40 g, 20 g y mixta (carbohidratos, proteínas y grasas). Cada dieta fue administrada a 10 sujetos e identificamos 3 tipos de vaciamiento gástrico: lento (117 ñ 12 minutos) en los que recibieron las dietas mixta, glucosada al 50%, proteinas 40 y 20 g; intermedio (83 ñ 9 minutos) con la glucosada al 5%, grasas 40 y 20 g; y rapido (40 ñ 6 minutos) con la salina isotónica. La dieta mixta tuvo el vaciamiento gástrico más lento (210 ñ 6 min). Nuestros resultados concuerdan con los conocimientos actuales de la fisiología motora del estómago y demuestran la utilidad de la ultrasonografía para el estudio del vaciamiento gástrico de líquidos

Contractions of the gastric antrum induced by stimulation of the medial forebrain bundle in the rat

Glucoreceptors sensitive to cytoglucopenia exist in the medial forebrain bundle of the rat. The selective activation of these receptors provokes an increase in glycemia and gastric secretion. In the present work, we found that stimulation of this diencephalic area in rats also provokes potent gastric contractions. Stimulation with high voltage usually inhibited this effect

Acute changes in extracellular fluid volume modify the antroduodenal flow of saline in dogs: a possible physiological role

The antroduodenal (AD) flow of saline was measured in anesthetized dogs following two different protocols of acute changes in extracellular fluid (ECF) volume, ECF expansion by in infusion of saline before or after hemorrhage decreased the AD flow; conversely, hemorrhage before or after expansion increased flow. These alternating modifications in the AD flow are independent of the sequence of volemic changes and may constitue part of the homeostatic responses of the gut to confront life-thratening situations such as accidental hyperhydration or hemorrhage

Myoelectric activity of gastric antrum and jejunum in anaesthetised guinea pigs.

The myoelectric activity of gastric antrum and jejunum was recorded in anaesthetised guinea pigs with Ag-AgCl electrodes. The investigation demonstrated the presence of slow waves and spike potentials. The variability in the pattern of myoelectric activity observed in our study might be due to anaesthesia.