A study of intragastric and intravesicular pressure changes during rest, coughing, weight lifting, retching, and vomiting.
BACKGROUND
In patients undergoing a variety of procedures, surgical success is in part dependent on maintaining normal intra-abdominal pressure in the immediate postoperative period. Our objective was to quantify intragastric and intravesicular pressures during activities, through the use of manometry catheters.


METHODS
Ten healthy volunteers had a manometry catheter placed transnasally, and a urinary Foley catheter placed. Baseline intragastric and intravesicular pressures were recorded and the catheters were then transduced continuously. Pressures were recorded with activity: coughing, lifting weights, retching (dry heaving), and vomiting.


RESULTS
All pressure changes were significant from baseline except for weight lifting. The highest intragastric pressure was 290 mmHg, seen during vomiting. Comparison of intragastric and intravesicular pressures showed no significant difference. There was significantly higher intragastric pressure with vomiting and retching as compared with coughing, whereas coughing applied more pressure than weight lifting.


CONCLUSIONS
This is the first report of intragastric pressures during vomiting and retching (dry heaving). We conclude that vomiting and retching (dry heaving) can render significant forces on any tissue apposition within the stomach or the peritoneal cavity.
Iqbal
Atif
A
Department of Surgery, University of Missouri Columbia, One Hospital Drive, Columbia, MO 65212, USA.
Haider
Mumnoon
M
Stadlhuber
Rudolf J
RJ
Karu
Anouki
A
Corkill
Sue
S
Filipi
Charles J
CJ
D000328:Adult; D003161:Compartment Syndromes / Q000503:physiopathology; D000075202:Contraindications; D003371:Cough / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007486:Ipecac / Q000633:toxicity; D008297:Male; D008365:Manometry / Q000379:methods; D011312:Pressure; D012016:Reference Values; D012146:Rest / Q000502:physiology*; D013270:Stomach; D013314:Stress, Mechanical; D013514:Surgical Procedures, Operative; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D001743:Urinary Bladder; D014839:Vomiting / Q000139:chemically induced / Q000503:physiopathology*; D014891:Weight Lifting / Q000502:physiology*; D055815:Young Adult
D007486:Ipecac