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Gut 59:i-ii doi:10.1136/gut.2010.212431
  • Digest

Digest

Intraluminal ultrasound and oesophageal shortening

Longitudinal muscle contraction is associated with oesophageal shortening. When exaggerated this shortening could lead to symptoms such as dysphagia, chest pain and heartburn. Oesophageal shortening has traditionally been monitored by tracking clips with fluoroscopy. High-frequency intraluminal ultrasound (HFIUS) has recently been proposed as an alternative method of evaluating oesophageal shortening in patients with oesophageal symptoms. Boesmans et al provide the first in vivo study comparing HFIUS measurements against fluoroscopy. They simultaneously assessed oesophageal shortening and muscle wall thickness in lightly sedated cats, using fluoroscopic tracking of endoscopically attached metal clips and HFIUS, respectively. Oesophageal shortening was studied during secondary peristalsis and oesophageal mucosal acidification (see figure). Apart from validating the use of HFIUS against the more cumbersome metal clip tracking by fluoroscopy, the authors also showed that oesophageal mucosal acidification provokes basal oesophageal shortening and secondary peristaltic contractions associated with strong and prolonged oesophageal shortening. This technique should now be transferrable to humans. See page 433

Correlation between muscle wall thickness and oesophageal shortening. Baseline muscle wall thickness (% thickening) and oesophageal shortening (% shortening) correlate significantly (r¼0.69266; p¼0.0042) during mucosal acidification.

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