Esophageal motility testing made easy by C G Bremner

By C G Bremner

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R--~--:",-"",-::""~ ............ ~:-... --:-:~ -_ ", ; Fig. 2-23 . .. J~S:'~A~, ' : :-:-:::-:':"~:::'::"-:-':":>:r-:-:'-::::::'~:'::':':"'::--:'::>'c'::~:-::'':::--'::':':-:-:::'-:::'':''~'::'':'::'::-''~':-':--~'-'"""_:"""'::"":'C:"-e':-:-:->"~' 1,~c~~~~~MWV~'y~rl~'~lt~'N}fr)VY~~)'~hl~{~~~~A~WVI Copyrighted Material 4Q , . Esophag~al Motility Testing Mad~: Easy '. Ramp Intrabolus Pressure Ramp intrabolus pressure is a waveform on esophageal manometry that precedes the peristaltic upstroke resulting from a swallow and may be an indicator of outflow resistance.

1,6 T i",e (sec), Fig. 0 eM. 0· III 40-60 segMents Chan .. 6 :.. 0V. 6 TiMe (sec) Copyrighted Material 371 38- ' Esophageal Motility Testing Made Easy 'c The Cardiac Impression A cardiac impression may be seen in a segment of the body study during a pullthrough recording. It is evidenced by an EKG-like pattern that differs from the normal respiratory deflections. The pressure is positive to the intragastric baseline pressure. This positive pressure is evident only in the channels traversing the same segment in other channels and should not be confused with the positive pressure seen in achalasia.

An interrupted sequence (C) is defined as a series of detectable contractions in which an initial contraction is followed by no detectable contractions «10 mrn Hg) with a normal contraction subsequently reappearing, whereas a dropped sequence (D) is defined as a series of detectable contractions in which an initial contraction was followed by no detectable contractions. The morphology of the contractions is classified as normal, multipeaked, or repetitive. The difference between multipeaked (E) and repetitive (F) is that the pressure between two consecutive peaks returns to the baseline in the latter.

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