Esophagogastric junction in systemic sclerosis: A study with the functional lumen imaging probe

2017 ◽  
Vol 29 (8) ◽  
pp. e13073 ◽  
Author(s):  
L. Fynne ◽  
D. Liao ◽  
K. Aksglaede ◽  
C. Lottrup ◽  
H. Gregersen ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Esophagogastric Junction ◽  
Imaging Probe ◽  
Functional Lumen Imaging Probe

Estimation of mechanical work done to open the esophagogastric junction using functional lumen imaging probe panometry

2021 ◽  
Author(s):  
Shashank Acharya ◽  
Sourav Halder ◽  
Dustin A Carlson ◽  
Wenjun Kou ◽  
Peter J. Kahrilas ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Treatment Response ◽  
Eosinophilic Esophagitis ◽  
Esophagogastric Junction ◽  
Mechanical Work ◽  
Imaging Probe ◽  
Functional Lumen Imaging Probe ◽  
A Value ◽  
Work Done ◽  
The Relationship

Background: In this study, we quantify the work done by the esophagus to open the esophagogastric junction (EGJ) and create a passage for bolus flow into the stomach. Work done on the EGJ was computed using functional lumen imaging probe (FLIP) panometry. Methods: Eighty-five individuals underwent FLIP panometry with a 16 cm catheter during sedated endoscopy including asymptomatic controls (n=15), 45 achalasics (n=15 each, three subtypes), GERD (n=13), eosinophilic esophagitis (EoE; n=8) and systemic sclerosis (SSc; n=5). Luminal CSA and pressure were measured by the FLIP catheter positioned across the EGJ. Work done on the EGJ (EGJW) was computed (millijoules, mJ) at 40 mL distension. Additionally, a separate method was developed to estimate the "work required" to fully open the EGJ (EGJROW) when it did not open during the procedure. Results: EGJW for controls had a median (IQR) value of 75 (56-141) mJ. All achalasia subtypes showed low EGJW compared to controls (p<0.001). GERD and EoE subjects had EGJW 54.1 (6.9-96 .3) and 65.9 (10.8-102.3) mJ, similar to controls (p<0.08 and p<0.4, respectively). The scleroderma group showed low values of EGJW, 12 mJ (p<0.001). For achalasics, EGJROW was the greatest and had a value of 210.4 (115.2-375.4) mJ. Conclusions: Disease groups with minimal or absent EGJ opening showed low values of EGJW. For achalasics, EGJROW significantly exceeded EGJW values of all other groups highlighting its unique pathophysiology. Balancing the relationship between EGJW and EGJROW is potentially useful for calibrating achalasia treatments and evaluating treatment response.

Esophagogastric junction distensibility measured by a functional lumen imaging probe with incremental gastric myotomy lengths in achalasia

2015 ◽  
Vol 30 (5) ◽  
pp. 2139-2140
Author(s):  
Rym El Khoury ◽  
Joel M. Sternbach ◽  
Ezra N. Teitelbaum ◽  
Nathaniel J. Soper ◽  
Eric S. Hungness
Keyword(s):  
Esophagogastric Junction ◽  
Imaging Probe ◽  
Functional Lumen Imaging Probe

The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction

2007 ◽  
Vol 292 (1) ◽  
pp. G377-G384 ◽  
Author(s):  
Barry P. McMahon ◽  
Jens B. Frøkjær ◽  
Peter Kunwald ◽  
Donghua Liao ◽  
Peter Funch-Jensen ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Dynamic Activity ◽  
Cross Sectional ◽  
Imaging Probe ◽  
Functional Lumen Imaging Probe ◽  
New Methods ◽  
Dynamic Technique ◽  
Balloon Distension ◽  
Before And After ◽  
Difficult Cases

There is a need for new methods to study the dynamics of the esophagogastric junction (EGJ). The aims were to verify the efficacy and usefulness of a “functional lumen imaging probe” (FLIP) for the evaluation of the EGJ. Eight healthy volunteers (6 men), median age 26 (21–35) yr, and two achalasia patients underwent the FLIP procedure. The EGJ was located by manometry. The FLIP measured eight cross-sectional areas (CSAs) 4 mm apart together with the pressure inside a saline-filled cylindrical bag. The data showed the geometric profile of the EGJ reconstructed in a video animation of its dynamic activity. A plot of curve-fitted data for the smallest CSA vs. pressure after balloon distension indicated that the pressure increased from 18 cmH2O at a CSA of 38 mm2 to a pressure of 37 cmH2O at a CSA of 230 mm2 for the healthy controls. In one achalasia patient (unsuccessfully treated with dilations), the CSA never rose above the minimal measurable value despite the pressure increasing to 50 cmH2O. In another achalasia patient (successfully treated with dilations), the pressure only reached 15 cmH2O despite opening to a CSA of 250 mm2. In conclusion, FLIP represents the first dynamic technique to profile the function and anatomy of the EGJ. The method can be used practically to evaluate difficult cases of EGJ dysfunction and may provide a role in evaluating patients before and after therapies for diseases affecting the EGJ such as achalasia and gastroesophageal reflux disease.

595 Functional Lumen Imaging Probe to Assess Geometric Changes in the Esophagogastric Junction Following Endolumenal Fundoplication

2010 ◽  
Vol 138 (5) ◽  
pp. S-855-S-856
Author(s):  
Toshitaka Hoppo ◽  
Barry P. McMahon ◽  
Bart P. Witteman ◽  
Stefan J. Kraemer ◽  
Robert W. O'Rourke ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Imaging Probe ◽  
Functional Lumen Imaging Probe ◽  
Geometric Changes
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