Manometric study of hiatal hernia and its correlation with esophageal peristalsis.

摘要: The pathogenesis of gastroesophageal reflux disease (GERD) is considered multifactorial, but alterations the esophagogastric junction (EGJ) and hiatal hernia play a prominent role. correlations between other pathogenetic factors are as yet unclear, they need to be investigated by methodological approach based on new anatomic functional criteria. Our aim was study, stationary manometry, relationships small reducible hernia, identified endoscopy, esophageal peristalsis, in patients with without GERD. According absence or presence esophagitis (E), (H), 58 subjects were divided into four groups: controls 10; H 14; E HE 24. Stationary manometry performed rapid pull-through (RPT) technique, catheter water perfused, study lower high pressure zone [lower sphincter (LES) diaphragmatic crura] parameters peristalsis. In various combinations peak and/or deflection manometric line five EGJ profiles, only one which reveals (by one-peak profile due superimposed LES crura) reducibility hernia. frequency profiles calculated two-peak significantly more prevalent these patients, although less so group esophagitis. distal amplitude propagation waves than three groups (P < 0.05 vs HE; P 0.01 H). Furthermore, higher 0.01). results show better definition morphology, via RPT disclosing profiles. addition, significant link found GERD wave esophagus. amplification peristaltic clearing may initial protective process against acid reflux; breakdown this mechanism trigger pathological sequence