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Abnormal esophageal body function: radiographic-manometric correlation.

L Fuller1, J E Huprich, J Theisen

  • 1Department of Surgery, University of Southern California School of Medicine, Los Angeles 90033, USA.

The American Surgeon
|October 9, 1999
PubMed
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Videoesophagram shows limited sensitivity for detecting esophageal motility disorders. While less sensitive overall, it is useful for identifying patients with achalasia, scleroderma, or dysphagia who may benefit from surgery.

Area of Science:

  • Gastroenterology
  • Esophageal Physiology
  • Diagnostic Imaging

Background:

  • Stationary manometry is the established standard for diagnosing esophageal motility disorders.
  • Objective comparisons between videoesophagram and manometry for evaluating these disorders are lacking.

Purpose of the Study:

  • To compare the diagnostic accuracy of videoesophagram with stationary manometry in patients with foregut symptoms.

Main Methods:

  • Two hundred two patients underwent both stationary manometry and videoesophagram.
  • Videoesophagram assessed esophageal body function based on barium stasis.
  • Abnormal manometry was defined by specific contraction amplitude and wave pattern criteria.

Main Results:

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  • Sixty-two patients had abnormal manometry; 34 also had abnormal videoesophagrams.
  • Overall sensitivity of videoesophagram was 55%, with a positive predictive value of 53%, specificity of 79%, and negative predictive value of 80%.
  • Highest sensitivity was observed in achalasia (94%), scleroderma (100%), and dysphagia (89%).

    • Conclusions:

    • Videoesophagram demonstrates relatively low sensitivity for detecting esophageal motility disorders, particularly nonspecific types.
    • It is most valuable for identifying patients with esophageal dysfunction amenable to surgical intervention and those with dysphagia.