Manometrical evaluation in visceral neuropathies in children

Manometrical recordings were made at three levels of the digestive tract in 20 children with chronic intestinal pseudoobstruction (CIPO) defined clinically and histopathologically by deep biopsies showing a neuropathic process. Duodenal manometry showed severe abnormalities with hypomotility in all cases and absence of migrating motor complex in 13 of 20 cases. There was no relation between the histopathologic type and the motility pattern, but the most severe abnormalities were seen in the patients with extensive involvement of the digestive tract and the most severe clinical course. Esophageal manometry was abnormal in 18 of 19 patients, with altered peristalsis consisting of simultaneous, short-lasting, or low-amplitude waves. Rectoanal manometry showed the presence of the rectosphincteric inhibitory reflex in all patients. In conclusion, there is a high frequency of small bowel manometrical abnormalities in CIPO which seem to correlate with the extent of the pathological process and the prognosis of the disease. Esophageal manometry is useful for defining the extent of dysmotility and confirming the diagnosis of CIPO in some cases.