The usefulness of videomanometry for studying pediatric esophageal motor disease.
OBJECTIVE
Abnormalities in esophageal motor function underlie various symptoms in the pediatric population. Manometry remains an important tool for studying esophageal motor function, whereas its analyses have been conducted with considerable subjective interpretation. The usefulness of videomanometry with topographic analysis was examined in the current study.


METHODS
Videomanometry was conducted in 5 patients with primary gastroesophageal reflux disease (GERD), 4 with postoperative esophageal atresia (EA), 1 with congenital esophageal stenosis (CES), and 1 with diffuse esophageal spasms (DES). Digitized videofluoroscopic images were recorded synchronously with manometric digital data in a personal computer. Manometric analysis was conducted with a view of concurrent esophageal contour and bolus transit.


RESULTS
Primary GERD patients showed esophageal flow proceeding into the stomach during peristaltic contractions recorded manometrically, whereas patients with EA/CES frequently showed impaired esophageal transit during defective esophageal peristaltic contractions. A characteristic corkscrew appearance and esophageal flow in a to-and-fro fashion were seen with high-amplitude synchronous esophageal contractions in a DES patient. The topographic analysis showed distinctive images characteristic of each pathological condition.


CONCLUSIONS
Videomanometry is helpful in interpreting manometric data by analyzing concurrent fluoroscopic images. Topographic analyses provide characteristic images reflecting motor abnormalities in pediatric esophageal disease.
Kawahara
Hisayoshi
H
Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
Kubota
Akio
A
Okuyama
Hiroomi
H
Oue
Takaharu
T
Tazuke
Yuko
Y
Okada
Akira
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015154:Esophageal Motility Disorders / Q000503:physiopathology*; D005471:Fluoroscopy; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008365:Manometry / Q000379:methods*; D014741:Video Recording