Endoscopy- and Monitored Anesthesia Care-Assisted High-Resolution Impedance Manometry Improves Clinical Management

Case Reports in Gastrointestinal Medicine
Kaci E ChristianGuofeng Xie

Abstract

High-resolution impedance manometry (HRiM) is the test of choice to diagnose esophageal motility disorders and is particularly useful for identifying achalasia subtypes, which often guide therapy. HRiM is typically performed without sedation in the office setting. However, a substantial number of patients fail this approach. We report our single-center experience on endoscopy-assisted HRiM under monitored anesthesia care (MAC) in adults to demonstrate the feasibility and effectiveness of this approach. Patients who had failed prior HRiM attempts received propofol under MAC. Patients then underwent an upper endoscopy, followed immediately by passage of a Diversateck HRiM motility catheter through the nares and under direct visualization into the stomach, often using the tip of the endoscope to guide the catheter. We then awakened the patients and asked them to perform 10 saline swallows. We successfully completed HRiM studies in 14 consecutive patients. Six patients had achalasia; two had esophagogastric junction outflow obstruction; two had absent contractility; one had distal esophageal spasm; one had ineffective esophageal motility; and one had a normal study. The majority of these patients were treated successfully with targ...Continue Reading

References

Dec 31, 1998·Gastrointestinal Endoscopy·A J CameronS F Phillips
Dec 21, 2000·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·C ErtekinI Aydogdu
Sep 29, 2007·The American Journal of Gastroenterology·John E PandolfinoPeter J Kahrilas
Aug 23, 2011·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Sabine RomanJohn E Pandolfino
Feb 22, 2012·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·A J BredenoordUNKNOWN International High Resolution Manometry Working Group
Sep 4, 2014·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ahmed M SharataLee L Swanström
Dec 4, 2014·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·P J KahrilasUNKNOWN International High Resolution Manometry Working Group
Apr 5, 2017·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·F SchlottmannM G Patti

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Citations

Oct 2, 2020·Curēus·Dhineshreddy GuralaStephen M Mulrooney

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Methods Mentioned

BETA
sedation
biopsy
motility studies

Software Mentioned

Diversatek ZVU

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