Intragastric maldistribution of a liquid meal in patients with reflux oesophagitis assessed by three dimensional ultrasonography.
OBJECTIVE
Our aim was to study intragastric volume and distribution of a liquid meal in patients with reflux oesophagitis using three dimensional ultrasonography.


METHODS
Twenty patients and 20 healthy controls underwent ultrasonographic measurements of the stomach using a position sensor based on magnetic scanhead tracking for acquisition of three dimensional images. In vivo accuracy of the method was evaluated by scanning a soup filled barostat bag positioned in the proximal stomach of six healthy subjects.


RESULTS
In the volume range 100-700 ml, our three dimensional system showed excellent correlation (r=0.99) between estimated and true volumes (limits of agreement -3.4 to 11.0 ml) and a low interobserver variation (limits of agreement -10.9 to 6.7 ml). After ingestion of a 500 ml meat soup meal, patients with reflux oesophagitis revealed a larger volume of the total and proximal stomach at two and 10 minutes (p=0.05; p=0.01, respectively), and an increased proximal/distal intragastric volume ratio at 10 minutes (p=0.04). Patients also experienced more epigastric fullness than controls (p=0.0006).


CONCLUSIONS
The present three dimensional ultrasound system showed excellent agreement with true volumes and low interobserver variation. Soon after a liquid meal, patients with reflux oesophagitis have abnormal pooling of the ingested liquid in the proximal stomach.
Tefera
S
S
Division of Gastroenterology, Institute of Medicine, Haukeland Hospital, University of Bergen, Norway. stef@haukeland.no
Gilja
O H
OH
Olafsdottir
E
E
Hausken
T
T
Hatlebakk
J G
JG
Berstad
A
A
D000328:Adult; D004942:Esophagitis, Peptic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005502:Food; D005746:Gastric Emptying / Q000502:physiology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D019518:Postprandial Period; D015203:Reproducibility of Results; D013270:Stomach / Q000000981:diagnostic imaging; D014463:Ultrasonography