The Lower Esophageal Sphincter Shown by a Computerized Representation

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Abstract
The clinical application of manometry of the lower esophageal sphincter (LES) remains controversial. This is because of the large variability in recorded lower esophageal sphincter pressure (LESP). In this paper a computerized method providing a three-dimensional image of the LES is described. In 12 healthy subjects end-expiratory rapid pull-through LESP recordings were performed for 1 h, using a perfused 8-channel probe. A cylindric model of the sphincter was calculated by means of a graphics program. The graphic representation of the LES demonstrated a circular pressure zone that was affected by the gastric migrating motility complex. This pressure zone was located proximal to a persistent indentation in the posterior and right posterolateral direction. Three-dimensional visualization of the LES provides additional information that cannot be obtained by the usually used techniques of analysis of sphincter manometry.