Ileal manometry in children following ileostomies and pull-through operations.
Our aim was to analyse the patterns of ileal contractions in children. We reviewed the charts of 23 children who had ileal manometry studies (16 males), mean age 7 years (range 2 months to 17 years). We positioned the manometry catheters with 4-8 recording sites, 5 or 15 cm apart, through ileostomies fashioned for clinically indicated reasons. We studied six additional children with persistent faecal soiling following endorectal pull through for Hirschsprung's disease; the catheters were positioned through the anus and colon into the ileum. We recorded phasic and tonic intermittent contractions in all the subjects, clustered contractions (rate 5-9 min-1, duration 20-120 s) in 19 subjects with ileostomies and four with endorectal pull throughs. In 13 children there were prolonged propagated contractions, > 60 mmHg in amplitude, > 15 s in duration, propagating at rates of 2-6 cm s-1 over at least 20 cm. The migrating motor complex was rare; in 55 h of fasting recording there were two phase III sequences. There are four distinctive features of ileal manometry recordings in children: random intermittent contractions, clustered contractions, prolonged propagated contractions and tonic contractions. The features of ileal motility differ from motility in the proximal small bowel.
Sood
M R
MR
Department of Paediatric Gastroenterology, Booth Hall Children's Hospital, Manchester, UK. manursood@yahoo.com
Cocjin
J
J
Di Lorenzo
C
C
Narasimha Reddy
S
S
Flores
A F
AF
Hyman
P E
PE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005215:Fasting / Q000502:physiology; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000502:physiology* / Q000601:surgery; D007223:Infant; D008297:Male; D008365:Manometry; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D019518:Postprandial Period / Q000502:physiology; D012189:Retrospective Studies