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World J Gastroenterol. May 14, 2006; 12(18): 2818-2824
Published online May 14, 2006. doi: 10.3748/wjg.v12.i18.2818
Functional oesophago-gastric junction imaging
Barry P McMahon, Asbjørn Mohr Drewes, Hans Gregersen
Barry P McMahon, Department of Medical Physics and Clinical Engineering, Adelaide and Meath Hospital Dublin, Incorporating the National Children’s Hospital, Tallaght, Dublin 24, Ireland
Asbjørn Mohr Drewes, Hans Gregersen, Centre for Visceral Biomechanics & Pain, Aalborg Hospital, Aalborg, Denmark
Correspondence to: Dr. Barry P McMahon, Department of Medical Physics & Clinical Engineering, Adelaide & Meath Hospital, Tallaght, Dublin 24, Ireland. barry@mech-sense.com
Telephone: +353-1-4145898 Fax: +353-1-4142501
Received: March 25, 2006
Revised: March 28, 2006
Accepted: April 10, 2006
Published online: May 14, 2006
Abstract

Despite its role in disease there is still no definitive method to assess oesophago-gastric junction competence (OGJ). Traditionally the OGJ has been assessed using manometry with lower oesophageal sphincter pressure as the indicator. More recently this has been shown not to be a very reliable marker of sphincter function and competence against reflux. Disorders such as gastro-oesophageal reflux disease and to a lesser extend achalasia still effects a significant number of patients. This review looks at using a new technique known as impedance planimetry to profile the geometry and pressure in the OGJ during distension of a bag. The data gathered can be reconstructed into a dynamic representation of OGJ action. This has been shown to provide a useful representation of the OGJ and to show changes to the competence of the OGJ in terms of compliance and distensibility as a result of endoluminal therapy.

Keywords: Oesophagogastric junction, Lower oesophageal sphincter, Competence, Distensibility, Functional imaging