scholarly journals High-resolution manometry in the diagnosis and classification of achalasia in children

2020 ◽  
Vol 50 (1) ◽  
Author(s):  
Erick Toro-Monjaraz ◽  
Rubén Peña-Vélez ◽  
María José Carrillo-Quan ◽  
David Avelar-Rodríguez ◽  
Martha Cecilia Martínez-Soto ◽  
...  
Keyword(s):  
High Resolution ◽  
Pediatric Patients ◽  
Case Series ◽  
Esophageal Achalasia ◽  
Motor Disorder ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Diagnosis And Classification ◽  
Esophageal Sphincter

Esophageal achalasia is a primary motor disorder that presents with dysphagia secondary to esophageal body dysfunction and functional obstruction of the lower esophageal sphincter. High-resolution manometry is considered the gold standard for the diagnosis of achalasia and, according to the Chicago classification v3.0; it can be further divided into three different subtypes based on the pressurization patterns. Herein, we present the case series of 6 pediatric patients in whom high-resolution manometry was performed for the diagnosis and classification of esophageal achalasia.

scholarly journals High-resolution esophageal manometry in patients with achalasia

2021 ◽  
Vol 180 (1) ◽  
pp. 45-53
Author(s):  
A. A. Smirnov ◽  
M. M. Kiriltseva ◽  
M. E. Luybchenko ◽  
L. I. Davletbaeva ◽  
A. V. Kochetkov
Keyword(s):  
High Resolution ◽  
Lower Esophageal Sphincter ◽  
Esophageal Manometry ◽  
Esophageal Achalasia ◽  
X Rays ◽  
High Resolution Manometry ◽  
Prospective Group ◽  
Unified View ◽  
Esophageal Sphincter ◽  
Integrated Relaxation Pressure

Introduction. At present, high-resolution esophageal manometry is the «gold standard» for the diagnosis of esophageal achalasia, based on the determination of the integrated relaxation pressure of the lower esophageal sphincter, the value of which in the case of achalasia must exceed 15 mm Hg (MMS System). However, in some patients with clinically and radiologically confirmed achalasia, this value is normal. There is no unified view of the cause of this phenomenon. We assumed that low pressure figures may be affected by incorrect installation of the manometric catheter.Methods and materials. This research included 149 patients (61 by retrospective estimating the patients data and 88 new patients) with achalasia established during the period from January 2017 to March 2020. When it was impossible to localize the lower esophageal sphincter and take correct measurements during high-resolution manometry in new patients, the X-rays or upper endoscopy was performed to control the manometric catheter placement. If its’ placement was incorrect and the integrated relaxation pressure level was lower than 15 mmHg, repeated high-resolution manometry was performed with the over-the-guidewire manometric catheter placing.Results. In 36 patients of both groups (24.2 %), the manometric data did not correspond to esophageal achalasia; in the prospective group, 12 out of the 19 patients had incorrect manometric data due to inability to visualize lower esophageal sphincter. In the prospective group, the manometric catheter was reinstalled by a guidewire, which allowed visualizing the signs of the lower esophageal sphincter in all cases, and in 15 out of 19 patients (79 %), the integrated relaxation pressure of the lower esophageal sphincter was more than 15 mm Hg.Conclusions. In some cases, the over-the-guidewire installing makes it possible to pass catheter through the lower esophageal sphincter correctly, visualize the lower esophageal sphincter during the high-resolution manometry examination and obtain true pressure values.

Su1885 Radiographic and Symptomatic Characteristics Among the 3 Subtypes of Esophageal Achalasia Defined by Chicago Classification With High-Resolution Manometry

2013 ◽  
Vol 144 (5) ◽  
pp. S-500
Author(s):  
Hiroko Hosaka ◽  
Akiyo Kawada ◽  
Shiko Kuribayashi ◽  
Yasuyuki Shimoyama ◽  
Masaki Maeda ◽  
...  
Keyword(s):  
High Resolution ◽  
Esophageal Achalasia ◽  
High Resolution Manometry ◽  
Chicago Classification

Sa1353 Ept Correlates of IEM in the Chicago Classification of High Resolution Manometry

2012 ◽  
Vol 142 (5) ◽  
pp. S-280
Author(s):  
Yinglian Xiao ◽  
Sabine Roman ◽  
Frédéric Nicodème ◽  
Annemijn de Ruigh ◽  
Peter J. Kahrilas ◽  
...  
Keyword(s):  
High Resolution ◽  
High Resolution Manometry ◽  
Chicago Classification

scholarly journals A PICTORIAL PRESENTATION OF ESOPHAGEAL HIGH RESOLUTION MANOMETRY CURRENT PARAMETERS

2017 ◽  
Vol 30 (1) ◽  
pp. 69-71 ◽  
Author(s):  
Fernanda M. LAFRAIA ◽  
Fernando A. M. HERBELLA ◽  
Julia R. KALLUF ◽  
Marco G. PATTI
Keyword(s):  
High Resolution ◽  
Lower Esophageal Sphincter ◽  
Esophageal Motility ◽  
Clinical Applications ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Pictorial Presentation ◽  
New Concepts ◽  
Esophageal Sphincter ◽  
Integrated Relaxation Pressure

ABSTRACT Introduction: High resolution manometry is the current technology used to the study of esophageal motility and is replacing conventional manometry in important centers for esophageal motility with parameters used on esophageal motility, following the Chicago Classification. This classification unifies high resolution manometry interpretation and classifies esophageal disorders. Objective: This review shows, in a pictorial presentation, the new parameters established by the Chicago Classification, version 3.0, aimed to allow an easy comprehension and interpretation of high resolution manometry. Methods: Esophageal manometries performed by the authors were reviewed to select illustrative tracings representing Chicago Classification parameters. Results: The parameters are: Esophagogastric Morphology, that classifies this junction according to its physiology and anatomy; Integrated Relaxation Pressure, that measures the lower esophageal sphincter relaxation; Distal Contractile Integral, that evaluates the contraction vigor of each wave; and, Distal Latency, that measures the peristalsis velocity from the beginning of the swallow to the epiphrenic ampulla. Conclusion: Clinical applications of these new concepts is still under evaluation.

scholarly journals Physiological and pathological roles of the accommodation response in lower esophageal sphincter relaxation during wet swallows

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Muta ◽  
Eikichi Ihara ◽  
Shohei Hamada ◽  
Hiroko Ikeda ◽  
Masafumi Wada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Relaxation Function ◽  
Esophagogastric Junction ◽  
Prospective Observational Study ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

AbstractThe preparatory accommodation response of lower esophageal sphincter (LES) before swallowing is one of the mechanisms involved in LES relaxation during wet swallows, however, the physiological and/or pathological roles of LES accommodation remain to be determined in humans. To address this problem, we conducted a prospective observational study of 38 patients with normal high-resolution manometry (HRM) and 23 patients with idiopathic esophagogastric junction outflow obstruction (EGJOO) to assess dry and wet swallows. The LES accommodation measurement was proposed for practical use in evaluating the LES accommodation response. Although swallow-induced LES relaxation was observed in both dry and wet swallows, LES accommodation (6.4, 3.1–11.1 mmHg) was only observed in wet swallows. The extent of LES accommodation was impaired in idiopathic EGJOO (0.6, − 0.6–6 mmHg), and the LES accommodation measurement of patients with idiopathic EGJOO (36.8, 29.5–44.3 mmHg) was significantly higher in comparison to those with normal HRM (23.8, 18–28.6 mmHg). Successful LES relaxation in wet swallowing can be achieved by LES accommodation in combination with swallow-induced LES relaxation. Impaired LES accommodation is characteristic of idiopathic EGJOO. In addition to the IRP value, the LES accommodation measurement may be useful for evaluating the LES relaxation function in clinical practice.

The upper esophageal sphincter in the high-resolution manometry era

2021 ◽  
Author(s):  
Pedro Norton ◽  
Fernando A. M. Herbella ◽  
Francisco Schlottmann ◽  
Marco G. Patti
Keyword(s):  
High Resolution ◽  
Upper Esophageal Sphincter ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

Sa1327 High-Resolution Manometry Assessment of the Lower-Esophageal Sphincter Aftercontraction: Normative Values and Clinical Significance

2016 ◽  
Vol 150 (4) ◽  
pp. S283-S284
Author(s):  
Dustin A. Carlson ◽  
Peter Kahrilas ◽  
Zoe Listernick ◽  
Yinglian Xiao ◽  
Vadim Bul ◽  
...  
Keyword(s):  
High Resolution ◽  
Lower Esophageal Sphincter ◽  
Clinical Significance ◽  
Normative Values ◽  
High Resolution Manometry ◽  
Esophageal Sphincter
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