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Abstract
Background Antroduodenal manometry (ADM) is one of the tests for the evaluation of gastric as well as duodenal motility. It is considered one of the most difficult diagnostic tests in neurogastroenterology, given the difficulty in placement of the catheter and the duration of the test involved.
Currently, available commercial ADM catheters are limited. With this initial study, we describe our initial experience using a novel wire-guided water-perfused catheter (KARE Catheter) with radio-opaque markers for performing antroduodenal manometry.
Methods Inclusion Criteria—Patients aged 18 years and above referred for evaluation of antro-duodenal dysmotility in suspected cases of gastroparesis or chronic idiopathic pseudo-obstruction underwent ADM using the novel KARE catheter. Patients had symptoms of diffuse or upper gastro-intestinal dysmotility, including postprandial bloating, recurrent vomiting, upper abdominal discomfort, and weight loss.
Exclusion Criteria- Mechanical Obstruction, inability to pass the catheter, negative consent for the procedure, age less than 18
11 patients underwent ADM at our referral Neuro-gastroenterology & GI motility lab using the novel KARE catheter.
Data collected was symptoms of the patient (taking the predominant symptom of the patient), age, sex, prior history of diabetes or foregut interventions (surgery or endoscopic), time taken for catheter insertion, successful completion of study defined as completion of all phases of test or demonstration of phase 3 antral MMCs during the study.
Results Catheter placement using the KARE catheter was successful in all the patients (IDDF2024-ABS-0347 Figure 1. Placement of KARE catheter). The mean time to insert a catheter was 8.8 minutes, with a median of 9 minutes (IQR 4). Spontaneous Phase 3 MMCs (IDDF2024-ABS-0347 Figure 2. Image acquired showing antral 3cpms and duodenal contractions using KARE) were identified in 9 out of 11 patients. Conversion to fed pattern was also seen in 9 out of 11 patients. Antral hypomotility, as well as duodenal hypomotility, was seen in 1 patient with small bowel pseudo-obstruction; the dominant frequency in the antrum was 1.7 cpm, and the antral amplitude was 35mmhg. 2 patients with gastroparesis also showed dominant frequencies below 3 cpm in the antrum.
Placement of KARE catheter.
Image acquired showing antral 3cpms and duodenal contractions using KARE.
Conclusions This novel wire-guided, radio-opaque, water-perfused high-resolution antro-duodenal catheter makes antro-duodenal manometry easier, with less time required for insertion and subsequent analysis.