Patient: Sample, Sample

Transcription

1 Patient: Sample, Sample Gender: Male Physician: Sample DOB / Age: 08/25/1984 Operator: Height: 6 ft Referring Physician: Procedure: Esophageal Manometry Examination Date: 09/22/2011 Swallow Composite (mean of 10 swallows) Resting Pressure Profile & Anatomy Basal Pressures* LES, respiratory mean(mmhg) 42.7 (13-43) UES mean(mmhg) 16.5 (34-104) Anatomy* LES proximal(cm) 47.8 LES length(cm) 4.7 ( ) LES intraabdominal(cm) 2.3 Esophageal length(cm) 29.0 Hiatal hernia No Motility* Distal contr. integral(mmhg-cm-s) ( ) Distal contr. int. (highest)(mmhg-cm-s) Residual Pressures* LES (mean)(mmhg) 10.5 (<15.0) UES (mean)(mmhg) 2.5 (<12.0) *Notes. Motility values are mean among swallows; Normal values in (xxx.x): Simultaneous contractions: Velocity > 8.0 cm/s; eslv: esleeve; 3SN, IRP, DCI, IBP - See manual definitions Lower Esophageal Sphincter Region Normal Esophageal Motility Normal Landmarks Number of swallows evaluated 10 Proximal LES (from nares)(cm) 47.8 High Resolution Parameters LES length(cm) Distal contractile integral(mean)(mmhg-cm-s) Esophageal length (LES-UES centers)(cm) 29.0 Distal contractile integral(highest)(mmhg-cm-s) Intraabdominal LES length(cm) 2.3 Contractile front velocity(cm/s) 1.3 <9.0 Hiatal hernia? No Chicago Classification LES Pressures Distal latency 12.1 Pressure meas. method esleev e,irp % failed (Chicago Classification) 0 Basal (respiratory mean)(mmhg) % premature contraction 0 Residual (mean)(mmhg) 10.5 <15.0 % rapid contraction 0 % large breaks 0 % small breaks 0 Upper Esophageal Sphincter Normal Pharyngeal / UES Motility Normal Mean basal pressure(mmhg) No. swallows evaluated 10 Mean residual pressure(mmhg) 2.5 < & N/A above UES Mean peak pressure(mmhg) 14.0 Chicago Classification Findings* EGJ: Normal Relaxation Mean IRP (10.5 mmhg) is less than 15 mmhg Esophageal body: Hypercontractile At least one swallow with DCI greater than 8000 Finding: Hypercontractile Esophagus; no EGJ outflow obstruction * Findings are based on published Chicago Classification scheme and are only intended to serve as a guide for patient diagnosis

2 Procedure After confirmation of potential allergies, a topical analgesic was used to numb the nares followed by trans-nasal insertion of a High Resolution Manometry Catheter. Pressure bands of both UES and LES were observed on the color contour. Patient instructed to take deep breath to verify placement of catheter; diaphragmatic pinch noted on inspiration. Patient was assisted to supine position and catheter was stabilized. Patient encouraged to relax while acclimating to catheter for approximately 5 minutes. A 30 second baseline pressure was obtained to identify the UES and LES followed by a series of wet swallows using 5 ccs room temperature water to assess esophageal motility. At the conclusion of the procedure; the catheter was removed. Indications Patient reports difficulty swallowing. Interpretation / Findings Impressions Dr. Sample

3 Landmark Id Landmark Id Swallow #1 Swallow #1 Swallow #2 Swallow #2

4 Swallow #3 Swallow #3 Swallow #4 Swallow #4 Swallow #5 Swallow #5

5 Swallow #6 Swallow #6 Swallow #7 Swallow #7 Swallow #8 Swallow #8

6 Swallow #9 Swallow #9 Swallow #10 Swallow #10

7 Normal Group / Mean #1 #2 #3 #4 #5 #6 #7 #8 #9 #10 ESOPHAGEAL MOTILITY LES residual pressure (mmhg) < Classic ManoView High Resolution Parameters Distal contractile integral (mmhg-cm-s) Distal contractile integral (highest in group) (mmhg-cm-s) Contractile front velocity (cm/s) < Chicago Classification Distal latency (sec) % failed (Chicago Classification) % premature contraction % rapid contraction % large breaks % small breaks UES / PHARYNGEAL MOTILITY UES residual pressure (mean) (mmhg) <