Individual inactivation of the sphincteric component of the gastroesophageal barrier causes reflux esophagitis in piglets.
OBJECTIVE
The lower esophageal sphincter and the diaphragmatic crural sling form the gastroesophageal barrier. This work shows that division of the sphincteric component alone suffices to induce reflux esophagitis in piglets.


METHODS
Male piglets underwent either sham operation (n = 7) or extramucosal myotomy of the gastroesophageal junction (n = 8). Before and 1 week after the operation, pull-through manometry was performed under sedation. Pressures taken on the 4 quadrants at 20 1-mm intervals on both time endpoints were compared by pairwise Wilcoxon tests. The distal esophagus was studied histologically after 8 weeks.


RESULTS
The pressure profiles did not change after sham operation. In contrast, they were significantly flattened in the distal half of the high-pressure zone after myotomy reflecting disappearance of the sphincteric component of the barrier. Esophagitis was seen in all myotomized piglets but in none from the sham group.


CONCLUSIONS
Lower esophageal sphincter myotomy alone with preservation of the crural sling induces reflux esophagitis in piglets. This animal, widely available and not too costly, is an excellent model for gastroesophageal research.
Vicente
Yvone
Y
Department of Surgery, Hospital Infantil "La Paz," Paseo de la Castellana, Madrid, Spain.
Rocha
Cecilia
C
Yu
Jiakang
J
Hernandez-Peredo
Guillermo
G
Martinez
Leopoldo
L
Perez-Mies
Belen
B
Tovar
Juan A
JA
D000818:Animals; D004942:Esophagitis, Peptic / Q000209:etiology*; D004943:Esophagogastric Junction / Q000502:physiology / Q000601:surgery*; D008297:Male; D008365:Manometry / Q000379:methods; D023421:Models, Animal; D011312:Pressure; D013552:Swine