THE RELATIONSHIP BETWEEN DISTURBED TRANSIT AND DILATED BOWEL, AND MANOMETRIC FINDINGS OF DILATED BOWEL IN PATIENTS WITH DUODENAL ATRESIA AND STENOSIS

To determine whether dilated bowel proximal to obstruction associated with duodenal atresia and stenosis is related to feeding problems afte r a surgical correction of obstruction, the authors reviewed retrospec tively the degree of bowel dilatation and disturbed transit as well as other clinical features in 18 duodenal atresia and 12 duodenal stenos is patients. A multivariate analysis was conducted to determine the po ssible correlation among them. The authors also evaluated the physiolo gical function of the dilated bowel in duodenal atresia and stenosis p atients (n = 8) by manometry of dilated bowel. The results were as fol lows. (1) In multivariate analysis, using the degree of disturbed tran sit as a dependent variable and using other clinical features as indep endent variables, the presence of postoperative complication and the e xistence of bowel dilatation 2 weeks after the operation were risk fac tors for disturbed transit. (2) One or two episodes of phase 3 were fo und in six of eight measured patients during the recorded period. The most distinctive manometric finding was the low contraction amplitude of both phase 2 and phase 3. These results indicate that dilated bowel was related to disturbed transit during the postoperative period, and that the low contraction amplitude of the dilated bower was the main pathophysiological feature. The tapering or plication of dilated bowel might be indicated in patients with a markedly dilated bowel. Copyrig ht (C) 1997 by W.B. Saunders Company.