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Timing, propagation, coordination, and effect of esophageal shortening during peristalsis

1997; Elsevier BV; Volume: 112; Issue: 4 Linguagem: Inglês

10.1016/s0016-5085(97)70125-2

1528-0012

Philippe Pouderoux, Shih‐Yao Lin, PJ Kahrilas,

Tracheal and airway disorders

Background & Aims: Minimal information exists on the elegant studies have shown that peristalsis is associated characteristics and effect of esophageal shortening with the deglutitive inhibition followed by sequenced during peristalsis in the human esophagus.The aim of contraction of the circular muscle. 7Videofluoroscopic 8 this study was to quantify esophageal shortening durand ultrafast computerized tomographic 9 imaging studing peristalsis and determine the relationship between ies suggest that the inhibited distal segment is open and shortening, circular muscle contraction, and generaserves a capacitance function before being emptied by the tion of propulsive force.Methods: Ten volunteers had advancing peristaltic contraction.However, even though three metal clips endoscopically affixed at the squamocircular muscle contraction is considered necessary to columnar junction and 4.5 and 9 cm proximal to it, propel the bolus during this clearance phase, neither the defining proximal and distal segments in the lower propagation velocity nor the strength of circular muscle esophagus.A strain gauge manometer was positioned contraction correlates well with esophageal propulsive within the proximal segment along with a traction force sensing balloon.Axial clip movement was assessed force as measured by a variety of techniques, leading with concurrent manometry and videofluoroscopy dursome authors to suggest that longitudinal muscle may ing swallowing to examine the determinants of propulhave a role in bolus propulsion. 3,10 -14To date, however, sive force.Results: Esophageal shortening was coordithis hypothesis has not been explored fully.nated with circular muscle contraction such that each The aim of this work was to describe the pattern of propagated distally as overlapping segments of conesophageal shortening during peristalsis and to detertraction at a velocity of about 2.5 cm/s.Propulsive mine the relative contributions of esophageal shortening force within the proximal segment occurred after shortand circular muscle contraction in generating esophageal ening, during the circular muscle contraction, with the propulsive force.Esophageal shortening was quantified magnitude of propulsive force correlated with the deby the relative movement of metal clips affixed to the gree of distal shortening.Conclusions: (1) Both circular and longitudinal esophageal muscle contraction occur Abbreviations used in this paper: C, clip; EMG, electromyography.in the contiguous segment proximal to the bolus. 6Partial