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Related Experiment Videos

Pressure profiles in ileal pouch outlets.

H E Myrvold, K O Jonsson

    Scandinavian Journal of Gastroenterology
    |January 1, 1979
    PubMed
    Summary

    Measuring continent ileostomy nipple valve pressure requires specific flow rates to avoid underestimation. Higher pressures were observed in continent patients with nipple valves compared to incontinent ones due to valve sliding.

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    Area of Science:

    • Urology
    • Gastroenterology
    • Surgical Engineering

    Background:

    • Continent ileostomy reservoirs are surgically created to manage fecal diversion.
    • The nipple valve is a crucial component for maintaining continence in these reservoirs.
    • Accurate pressure measurement is essential for understanding nipple valve function and potential complications.

    Purpose of the Study:

    • To determine the optimal conditions for measuring yield pressure in the nipple valve of continent ileostomies.
    • To compare pressure profiles in continent versus incontinent ileostomy outlets.
    • To investigate the relationship between pressure, valve function, and incontinence etiology.

    Main Methods:

    • In vitro determination of yield pressure measurement conditions using water-perfused open-tip catheters (Ch 8).
    • Establishment of appropriate perfusional flow rates (above 4-5 ml/min) to prevent underestimation of yield pressure.
    • In vivo pressure profile measurements in 31 patients with continent or incontinent ileostomy reservoirs, differentiating between nipple valve and non-nipple valve outlets.

    Main Results:

    • Perfusional flow rates below 4-5 ml/min lead to underestimation of nipple valve yield pressure.
    • Moderate increases in perfusional flow rate did not significantly alter measured pressure once optimal rates were used.
    • Continent patients with nipple valves exhibited significantly higher outlet pressures than incontinent patients with nipple valve sliding.
    • Patients incontinent due to fistula formation showed pressures comparable to continent patients.

    Conclusions:

    • Accurate pressure measurement in ileostomy nipple valves necessitates specific flow rates to ensure reliable yield pressure assessment.
    • Outlet pressure is a key differentiator between functional nipple valves in continent patients and those with incontinence due to valve sliding.
    • Pressure measurements provide valuable insights into the functional status of ileostomy reservoirs and the mechanisms of incontinence.

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