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Physiological Characteristics of the Human Pyloric Sphincter

1973; Elsevier BV; Volume: 64; Issue: 1 Linguagem: Inglês

10.1016/s0016-5085(73)80092-7

1528-0012

Robert S. Fisher, Sidney Cohen,

Gastrointestinal disorders and treatments

To investigate the physiological characteristics of the human pylorus, simultaneous measurements of intraluminal pressure and skin to mucosa potential difference were determined in 28 normal subjects.The radiographic junction of the stomach and duodenum was marked by a potential difference change of -33.7 ± 2.8 mv (mean ± SE) and a high pressure zone with an amplitude of 5.3 ± 0.5 mm Hg and a length of 1.5 ± 0.1 cm.A diminution in pressure at the pylorus occurred with antral peristalsis.During the infusion of 0.1 N HCI into the duodenum, pyloric pressure increased to 17.2 ± 1.4 mm Hg (P < 0.001).Pressure did not change during NaCl perfusion of the duodenum.The reflux of duodenal infusion solution into the stomach, as measured using a phenol red marker, was only 1.8 ± 0.9% during HCI perfusion compared with 34.2 ± 9.3% during NaCl perfusion (P < 0.001).The pyloric pressure also increased significantly with duodenal instillation of olive oil, amino acids, and glucose.These studies indicated that the human pylorus was characterized by a high pressure zone that: (a) relaxed with antral peristalsis; (b) contracted in response to endogenous duodenal stimuli; and (c) altered the retrograde movement of duodenal contents into the stomach.We suggest that the human pylorus is a true physiological sphincter.The junction of the stomach and duodenum is marked anatomically by a confluence of the gastric muscle layers into a prominent, thickened ring called the pylorus.Despite limited physiological investigation in man, it has been concluded that the gastric antrum and pylorus function only as a propulsive unit and that the pylorus does not possess independent sphinc-