Related Experiment Video
Updated: Oct 19, 2025
A Mouse Model of Intestinal Partial Obstruction
Published on: March 5, 2018
Enhancing the utility of antroduodenal manometry in pediatric intestinal pseudo-obstruction
Atchariya Chanpong1,2,3, Hannah Cronin1, Dyanne Rampling4
1Neurogastroenterology & Motility Unit, Gastroenterology Department, Great Ormond Street Hospital for Children, London, UK.
Insights
A new enhanced antroduodenal manometry (ADM) analysis and scoring system significantly improves diagnosis of pediatric intestinal pseudo-obstruction (PIPO) by correlating better with histopathology than conventional ADM methods.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Diagnostic Medicine
Background:
- Pediatric intestinal pseudo-obstruction (PIPO) diagnosis relies on antroduodenal manometry (ADM) and histopathology.
- Limited data exist on the reliability of ADM analysis and its correlation with histopathology.
- A need exists for improved ADM analysis protocols for PIPO diagnosis.
Purpose of the Study:
- To develop an enhanced ADM analysis protocol with a scoring system.
- To explore the correlation of this enhanced ADM analysis with histopathology in pediatric patients.
- To improve diagnostic accuracy for PIPO.
Main Methods:
- Included 40 children with suspected PIPO undergoing ADM and biopsies (April 2012-December 2019).
- Analyzed ADM using conventional and novel enhanced motility parameters.
- Developed a novel ADM score (GLASS score) and correlated analyses with histopathology.
Main Results:
- Conventional ADM showed no agreement with histopathology (p=0.197).
- Enhanced ADM analysis significantly correlated with histopathology (p=0.003).
- The enhanced ADM score differentiated PIPO from non-PIPO (16.0 vs. 8.0; p<0.001) and correlated with histopathological findings.
Conclusions:
- Enhanced ADM analysis and its scoring system effectively discriminate between PIPO and non-PIPO patients.
- This novel approach also differentiates between distinct histopathological pathologies.
- Further research is needed to validate enhanced ADM analysis in larger patient cohorts.
Background:
Antroduodenal manometry (ADM) and histopathology are currently employed to aid the diagnosis of pediatric intestinal pseudo-obstruction (PIPO). Limited data are available on the reliability of ADM analysis and its correlation with histopathology. We aimed to develop a protocol for enhanced analysis of ADM contractile patterns, including a scoring system, and explore whether this provided better correlation with histopathology.
Methods:
Children referred with suspected PIPO between April 2012-December 2019 who underwent both ADM and full-thickness biopsies were included. ADM tracings were analyzed using both standard (conventional ADM) and novel (enhanced ADM) motility parameters. A novel ADM score (GLASS score) was generated based on the enhanced ADM analysis. Conventional and enhanced ADM analyses were then correlated with histopathology.
Results:
Forty patients were included. Using conventional clinical criteria, 29 of these were diagnosed with PIPO and the other 11 with non-PIPO diagnoses. Twenty-three of the PIPO patients had abnormal histopathology: 6 myopathy, 4 neuropathy, 3 neuro-myopathy, and 10 non-specific changes. No agreement in diagnosis was found between conventional ADM analysis and histopathology (ϰ = 0.068; p = 0.197), whereas the latter significantly correlated with enhanced ADM analysis (ϰ = 0.191; p = 0.003). The enhanced ADM score was significantly higher in PIPO versus non-PIPO (16.0 vs. 8.0; p < 0.001).
Conclusions:
As opposed to conventional analysis protocols, the newly developed enhanced ADM analysis and associated score is not only able to discriminate between PIPO and non-PIPO patients, but also between distinct histopathological pathologies. Further studies are required to assess the utility of enhanced ADM analysis in larger populations.
Related Concept Videos
01:26Endoscopic Procedures V: ERCP
Patient...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...