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Clinical relevance of antroduodenal manometry
M A Verhagen1, M Samsom, R J Jebbink
1Gastrointestinal Motility Unit, University Hospital, Utrecht, The Netherlands. marcanne@knmg.nl
Objective:
To evaluate the outcome of antroduodenal manometry studies and their effect on the clinical treatment of patients.
Design:
A retrospective review of clinical antroduodenal manometric studies performed between September 1990 and March 1997 (n = 109).
Setting:
Tertiary referral centre.
Main Outcome Measures:
The predominant symptom, the indication for the study, the outcome and the clinical impact were scored. A positive impact was defined as an outcome that resulted in an alteration of the management of the patient (medication, surgery, feeding), established a new diagnosis, or resulted in new investigations or in referral to another specialist.
Results:
Full records were obtained from 91 studies in 85 patients (mean age 43 years). Nausea and vomiting were the most predominant symptoms (37.4%). In 49.5% of the cases, the test was performed due to suspicion of a generalized motor disorder. A normal outcome was found in 37 studies. Non-specific motor abnormalities were reported in 72% of the studies with an abnormal outcome. Pseudo-obstruction was diagnosed in 20%. The manometric studies resulted in a new therapy in 12.6%, a new diagnosis in 14.9%, and referral to another specialist in 8%. A positive clinical impact was found in 28.7% of the patients.
Conclusion:
Antroduodenal manometry can be a helpful diagnostic technique in a specialized centre. More research is needed to gain insight into the significance of the large number of non-specific abnormalities that are often found.