Abstract
Gastric and small bowel motor activity is less commonly evaluated. Such evaluations usually are conducted only at expert centers, because of a number of factors. The first is that the placement of manometry catheters into the small bowel requires either fluoroscopic or endoscopic guidance. As a word of caution, the delicate nature of modern high-resolution manometry catheters makes them highly susceptible to damage. Endoscopic placement can be quite traumatic to the solid-state sensors, leading to expensive repair. Secondly, the data acquisition is time-consuming and labor-intensive. The final factor is the greater expertise required for the interpretation of these studies, which are more complex than esophageal studies and have not been the subject of extensive literature.
Antroduodenal manometry (ADM) allows for evaluation of the gastric, duodenal, and proximal jejunal motor function. Typically, the manometry catheter is placed across the gastric pyloric channel. Extending into at least the proximal 20 cm of the small bowel allows simultaneous pressure measurements of both the antrum and the duodenum. Owing to the challenges of this measurement, few studies have assessed this technique in disease states. This chapter concentrates on normal ADM during fasting and post-prandial periods, as well as appropriate response to intravenous promotility agents (e.g., erythromycin) for provocative testing.
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Moosavi, S., Rezaie, A., Pimentel, M., Pichetshote, N. (2020). Antroduodenal Manometry. In: Atlas of High-Resolution Manometry, Impedance, and pH Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-27241-8_3
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DOI: https://doi.org/10.1007/978-3-030-27241-8_3
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