Document Detail


Contribution of standard oesophageal manometry in sliding hiatal hernia: from the gastro-oesophageal pressure gradient to the diagnosis.
MedLine Citation:
PMID:  19473892     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We tested whether gastro-oesophageal pressure gradient is augmented in sliding hiatal hernia and the yield of oesophageal manometry in diagnosing sliding hiatal hernia. METHODS: Patients with equivalent body mass index were categorised according to manometry and endoscopy in groups: (1) no sliding hiatal hernia (n=147); (2) sliding hiatal hernia solely at endoscopy (n=46); and (3) sliding hiatal hernia at manometry (n=22). The yield of manometry was assessed taking endoscopy as referential. RESULTS: Gastro-oesophageal pressure gradient was similar between groups both at inspiration (13.3+/-5.7 mm Hg vs. 13.6+/-5.4 mm Hg vs. 12.6+/-4.4 mm Hg; P=0.874) or expiration (5.1+/-3.8 mm Hg vs. 5.2+/-3.6 mm Hg vs. 5.1+/-3.7 mm Hg; P=0.767). Group 3 patients were older than those of groups 1 and 2 (59+/-10 vs. 42+/-15 vs. 45+/-13 years; P<0.001). Sliding hiatal hernia was larger when characterised by manometry than at endoscopy [4 cm (2.25-4.75) vs. 2 cm (2-3); P<0.001]. Manometry showed sensitivity of 28% (95%CI 19-40%), specificity of 97% (95%CI 93-99%) and positive predictive value of 82% (95%CI 63-92%) in diagnosing sliding hiatal hernia. CONCLUSIONS: By using manometry in patients with equivalent body mass index, sliding hiatal hernia presence and size are related with age rather than gastro-oesophageal pressure gradient. This technique may be clinically useful when positive for sliding hiatal hernia.
Authors:
F Fornari; L M P Fucilini; C Risson; L Rossi; A Gelain; S G S Barros
Publication Detail:
Type:  Journal Article     Date:  2009-05-26
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  41     ISSN:  1878-3562     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-09     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  886-90     Citation Subset:  IM    
Affiliation:
ENDOPASSO, Passo Fundo/RS, Brazil. FernandoFornari@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Analysis of Variance
Body Mass Index
Chi-Square Distribution
Esophagoscopy
Esophagus / physiopathology
Female
Hernia, Hiatal / diagnosis*,  physiopathology*
Humans
Male
Manometry / methods*
Middle Aged
Pressure
Sensitivity and Specificity
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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