Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry
World Journal of Gastroenterology, cilt.13, sa.39, ss.5245-5252, 2007 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 13 Sayı: 39
- Basım Tarihi: 2007
- Doi Numarası: 10.3748/wjg.v13.i39.5245
- Dergi Adı: World Journal of Gastroenterology
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.5245-5252
- Anahtar Kelimeler: ambulatory 24-h pH monitoring, cervical esophageal ultrasound, gastroesophageal reflux, esophageal manometry, esophageal refluxate
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: To determine the gastroesophageal refluxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) findings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS findings as a predictor of gastroesophageal reflux (GER). Methods: In 45/500 patients, refluxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduo denoscopy (EGD), 24-h pH monitoring and manometry. Results: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (/7 = 20) [Includes Group B: isolated proximal reflux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6), and Group D: both PR/DR (n = 8)]; Group E: no reflux (n = 13); and Group F: hypersensitive esophagus (HSE) (n = 5). Groups B + D indicated total PR patients (n = 14), Groups E + F reflux-negatives with HSE (n = 18), and Groups A + F reflux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry findings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid reflux and/or pathologic manometry finding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PR between Groups B + D and E (AUC = 0.775, P = 0.015). Conclusion: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study, but it was not diagnostic for CE WT. © 2007 WJG. All rights reserved.