03-Digestive-System消化系统课件.ppt

Part 6.Gastrointestinal Motility Gastrointestinal Motility Esophageal motility Gastroesophageal reflux Gastric emptying Intestinal motility 6.1 Esophageal motility 6.1.1 Technique The details of the imaging study vary from department to department. Technetium colloid has been most commonly used as a non-absorbable marker, although other alternatives are equally appropriate, such as 99mTc-DTPA. It is usually given in liquid form (with water) or semi-solid form. 6.1 Esophageal motility 6.1.2 Normal images It is conventional to divide the esophagus into upper, middle, and lower portions. Up to 10% of the bolus may remain normally in the lower esophagus. The remainder of the bolus of colloid should traverse the esophagus in under 15 s. Normal transit for upper, middle, and lower moieties of esophagus is 2, 4, and 6 seconds respectively. Condensed images maybe used to show the progress of activity through esophagus. The x-axis shows time and the y-axis is the spread of activity from mouth to stomach. 6.1 Esophageal motility 6.1.3 Clinical application The diagnosis of esophageal motility disorders is most commonly made with contrast radiography and esophageal manometry. 6.2 Gastroesophageal reflux 6.2.1 Clinical application Gastroduodenal reflux Normal Abnormal 6.3 Gastric emptying 6.3.1 Technique 99mTc or 111In labeled-DTPA may be combined into a meal that has liquid and solid phases. 6.3 Gastric emptying 6.3.2 Clinical application Gastroparesis can be seen as an idiopathic disorder or secondary to many conditions. The autonomic neuropathy of long-standing diabetes mellitus is the most common identifiable cause and develops in about 20%-30% of poorly controlled patients. Neither the type of diabetes nor the age of onset has been shown to predict the risk of developing diabetic gastroparesis. Rapid gastric emptying (dumping) may occur after gastric surgery as a result of altered vagal activity or in the Zollinger-Ellison syndrome as a result of acid hypersecretion