Clinical relevance of antroduodenal manometry.

OBJECTIVE To evaluate the outcome of antroduodenal manometry studies and their effect on the clinical treatment of patients. DESIGN A retrospective review of clinical antroduodenal manometric studies performed between September 1990 and March 1997 (n = 109). SETTING Tertiary referral centre. MAIN OUTCOME MEASURES The predominant symptom, the indication for the study, the outcome and the clinical impact were scored. A positive impact was defined as an outcome that resulted in an alteration of the management of the patient (medication, surgery, feeding), established a new diagnosis, or resulted in new investigations or in referral to another specialist. RESULTS Full records were obtained from 91 studies in 85 patients (mean age 43 years). Nausea and vomiting were the most predominant symptoms (37.4%). In 49.5% of the cases, the test was performed due to suspicion of a generalized motor disorder. A normal outcome was found in 37 studies. Non-specific motor abnormalities were reported in 72% of the studies with an abnormal outcome. Pseudo-obstruction was diagnosed in 20%. The manometric studies resulted in a new therapy in 12.6%, a new diagnosis in 14.9%, and referral to another specialist in 8%. A positive clinical impact was found in 28.7% of the patients. CONCLUSION Antroduodenal manometry can be a helpful diagnostic technique in a specialized centre. More research is needed to gain insight into the significance of the large number of non-specific abnormalities that are often found.