Antroduodenal manometry: experience from a tertiary care center.
BACKGROUND
Though antroduodenal manometry (ADM) is an important research tool, experience on its clinical utility is scanty.


METHODS
All ADM performed as a clinical service, using an 8-channel water perfusion system were retrospectively analyzed. Impact on clinical management was classified as: (1) new diagnosis made, (2) change in management (new drug, decision regarding surgical treatment), (3) further special investigation done, (4) referral to another specialty.


RESULTS
ADM was successful in 32/33 (97%) patients (age 30 years [range 8-71]); 6 patients were < 12 years old. Clinical impression before ADM was: chronic intestinal pseudo-obstruction (CIPO) in 16 (50%), suspected gastroparesis in 11 (34.3%), dyspepsia in 5 (15.6%). Consequent to ADM in patients with CIPO, a new diagnosis was made in two (intestinal neuronal dysplasia and celiac disease), new drugs were started in five, surgery was performed in three and specific referral was sought in three. ADM confirmed gastroparesis in 9 of 11 patients. A new diagnosis was made in three patients, new drugs were started in three, and three were referred. In five dyspeptic patients, ADM was normal and no therapy was suggested. Overall, eleven patients with CIPO and four with gastroparesis benefited after ADM.


CONCLUSIONS
ADM was found useful in CIPO and gastroparesis, helped in decision making regarding surgery; however in nonspecific indications its utility was limited.
Ghoshal
Uday C
UC
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. ghoshal@sgpgi.ac.in
Paliwal
Maneesh
M
Das
Kshaunish
K
Yachha
Surender K
SK
Sachdeva
Sanjeev
S
Misra
Asha
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004386:Duodenum / Q000502:physiology*; D005260:Female; D018589:Gastroparesis / Q000175:diagnosis; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000502:physiology*