High-resolution solid-state manometry of the antropyloroduodenal region


Frank K. Friedenberg MD, Gastroenterology Section, Temple University Hospital, 3401 N. Broad Street, Philadelphia, PA 19140, USA.
Tel: +1 215 707 3431; fax: +1 215 707 2684;
e-mail: frank.friedenberg@temple.edu


Abstract  Manometric recording from the pyloric channel is challenging and is usually performed with a sleeve device. Recently, a solid-state manometry system was developed, which incorporates 36 circumferential pressure sensors spaced at 1-cm intervals. Our aim was to use this system to determine whether it provided useful manometric measurements of the pyloric region. We recruited 10 healthy subjects (7 males : 3 females). The catheter (ManoScan360) was introduced transnasally and, in the final position, 15–20 sensors were in the stomach and the remainder distributed across the pylorus and duodenum. Patients were recorded fasting and then given a meal and recorded postprandially. Using pressure data and isocontour plots, the pylorus was identified in all subjects. Mean pyloric width was 2.1 ± 0.1 cm (95% CI: 1.40–2.40). Basal pyloric pressure during phase I was 9.4 ± 1.1 mmHg, while basal antral pressure was significantly lower (P = 0.003; 95% CI: 2.4–8.4). Pyloric pressure was always elevated relative to antral pressure in phase I. For phases II and III, pyloric pressure was 7.7 ± 2.3 mmHg and 9.4 ± 1.1 mmHg, respectively. Pyloric pressure increased similarly after both the liquid and solid meal. In addition, isolated pressure events and waves, which involve the pylorus, were readily identified.