Does an acute increase of intraabdominal pressure effect esophageal sphincter pressure?
OBJECTIVE
The study was designed to observe the acute alterations between lower esophageal sphincter (LES) and intraabdominal pressure (IAP) in patients undergoing diagnostic laparoscopy.


METHODS
Eleven patients (7 Male), aged 49 fitting the criteria for manometric research and diagnostic laparoscopy were studied. To measure the IAP in sterile conditions a new device (IAP measurement system) was set. Pressures at basal (b), during intraabdominal CO2 insufflations (min, m2, m3) and at the end of laparoscopy (me), were recorded simultaneously. All results were given as the difference between two maneuvers (A). Paired sample t-test was used.


RESULTS
The results were as follows; at the time of maximum CO2 insufflations: p delta m1-b; 24.25 vs. 14.64 mmHg, during the stabile insufflations: p delta m2-m1; -2.88 vs. 2.99 mmHg, p delta m3-m2; -0.70 vs. -0.82 mmHg and after deflation of CO2; end of the laparoscopy; p delta m(e)-m3; -16.73 vs. -16.65 mmHg for LESP and IAP respectively. The response of the LESP and IAP were similar in all phases (p > 0.05). Also alterations of pressures according to gender or presence of cirrhosis were found to be similar.


CONCLUSIONS
LESP is changed synchronously in the presence of acute pressure changes in IAP. Gender or presence of cirrhosis does not affect the response of LES.
Yilmaz
Nevin
N
Division of Gastroenterology, Harran University School of Medicine, Sanliurfa. nevinylmz@yahoo.com
Musoglu
Ahmet
A
Oner
Setenay
S
Bor
Serhat
S
D000328:Adult; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011446:Prospective Studies; D012016:Reference Values; D012737:Sex Factors