2
|
Serra C, Pallotti F, Bortolotti M, Caputo C, Felicani C, De Giorgio R, Barbara G, Nardi E, Labate AMM. A New Reliable Method for Evaluating Gallbladder Dynamics: The 3-Dimensional Sonographic Examination. JOURNAL OF ULTRASOUND IN MEDICINE 2016; 35:297-304. [PMID: 26740492 DOI: 10.7863/ultra.14.10033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/26/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The purpose of this study was to compare conventional 2-dimensional (2D) B-mode sonography with 3-dimensional (3D) sonography for assessing gallbladder volume and contractility. METHODS Gallbladder volume and contractility were evaluated in 32 healthy volunteers after fasting and abstinence from smoking for 8 hours and after a standardized balanced liquid meal. The gallbladder was evaluated with 2D sonography (with the use of the ellipsoid method) and with 3D sonography using a volumetric matrix probe. Both measurements were made by an operator who was skilled in sonography and an unskilled operator. The group of volunteers was subdivided into 2 subgroups including 16 participants, which represented the "2 moments" of acquisition by the techniques, particularly for the unskilled operator. RESULTS The postprandial volumes obtained with 3D sonography were significantly lower in comparison to the volumes obtained with 2D sonography (P= .013), and there was a significant difference between the measurements made by the skilled and unskilled operators only for 2D sonography (P< .001), whereas between the 2 moments of acquisition by the 3D technique, there was no significant difference. The reproducibility of the technique for evaluation of gallbladder volumes was higher for 3D sonography than 2D sonography, particularly for the postprandial evaluation. CONCLUSIONS The new 3D sonographic method using a volumetric matrix probe is a simple, reliable, and more reproducible technique than conventional 2D sonography, even if performed by an unskilled operator, and it allows a reliable stimulation test for a gallbladder dynamic study.
Collapse
Affiliation(s)
- Carla Serra
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| | - Francesca Pallotti
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| | - Mauro Bortolotti
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.).
| | - Carla Caputo
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| | - Cristina Felicani
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| | - Roberto De Giorgio
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| | - Giovanni Barbara
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| | - Elena Nardi
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| | - Antonio Maria Morselli Labate
- Department of Digestive System, Sant'Orsola-Malpighi Hospital and University of Bologna, Bologna, Italy (C.S., F.P., M.B., C.C., C.F., R.D.G., G.B.); and Laboratory of Biostatistics, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (E.N., A.M.M.L.)
| |
Collapse
|
3
|
Milinić N, Filipovic B, Lukić T, Marković O, Milisavljević N, Gajić M, Filipovic B. Ultrasonography analysis of gallbladder motility in patients with functional dyspepsia. Eur J Intern Med 2014; 25:156-9. [PMID: 24012325 DOI: 10.1016/j.ejim.2013.08.699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/12/2013] [Accepted: 08/13/2013] [Indexed: 01/18/2023]
Abstract
BACKGROUND Gallbladder motility has been studied in patients with functional gastrointestinal disorders, such as functional dyspepsia, irritable bowel syndrome and biliary disorders without gallstones and results of these observations are often inconclusive and conflicting. METHODS The investigation was performed on 180 therapy-naïve newly diagnosed patients with functional dyspepsia (97 females and 83 males), aged 20-79 in which we have investigate ultrasonographically parameters of gallbladder motility. RESULTS Bonferroni post hoc correction stressed that fasting gallbladder volume and ejection fraction were significantly distorted in individuals with postprandial distress syndrome, although, the residual gallbladder volume was significantly lower in patients with epigastric pain syndrome comparing with other examinees. Ejection fraction of the gallbladder negatively correlated with body mass index. CONCLUSION The impaired contractibility of the gall bladder in patients with functional dyspepsia, based on the results of this study, is illustrated by the changes in the ejection fraction, which was more pronounced in patients with the postprandial distress syndrome.
Collapse
Affiliation(s)
- Nikola Milinić
- Faculty of Medicine, University of Belgrade, Serbia; Department of Gastroenterohepatology Clinical and Hospital Center "Bezanijska Kosa," Belgrade, Serbia
| | - Branka Filipovic
- Faculty of Medicine, University of Belgrade, Serbia; Department of Gastroenterohepatology Clinical and Hospital Center "Bezanijska Kosa," Belgrade, Serbia.
| | - Tamara Lukić
- Faculty of Medicine, University of Belgrade, Serbia
| | - Olivera Marković
- Faculty of Medicine, University of Belgrade, Serbia; Department of Hematology Clinical and Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | | | - Milan Gajić
- Faculty of Medicine, University of Belgrade, Serbia; Institute for Medical Statistics, Belgrade, Serbia
| | - Branislav Filipovic
- Faculty of Medicine, University of Belgrade, Serbia; Institute of Anatomy "Niko Miljanic," Belgrade, Serbia
| |
Collapse
|
5
|
Di Ciaula A, Covelli M, Berardino M, Wang DQH, Lapadula G, Palasciano G, Portincasa P. Gastrointestinal symptoms and motility disorders in patients with systemic scleroderma. BMC Gastroenterol 2008; 8:7. [PMID: 18304354 PMCID: PMC2276219 DOI: 10.1186/1471-230x-8-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Accepted: 02/27/2008] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Studies on gastrointestinal symptoms, dysfunctions, and neurological disorders in systemic scleroderma are lacking so far. METHODS Thirty-eight scleroderma patients (34 limited, 4 diffuse), 60 healthy controls and 68 dyspeptic controls were scored for upper and lower gastrointestinal symptoms (dyspepsia, bowel habits), gastric and gallbladder emptying to liquid meal (functional ultrasonography) and small bowel transit (H2-breath test). Autonomic nerve function was assessed by cardiovascular tests. RESULTS The score for dyspepsia (mainly gastric fullness) was greater in scleroderma patients than healthy controls, but lower than dyspeptic controls who had multiple symptoms, instead. Scleroderma patients with dyspepsia had a longer disease duration. Fasting antral area and postprandial antral dilatation were smaller in scleroderma patients than dyspeptic and healthy controls. Gastric emptying was delayed in both scleroderma patients (particularly in those with abnormal dyspeptic score) and dyspeptic controls, who also showed a larger residual area. Despite gallbladder fasting and postprandial volumes were comparable across the three groups, gallbladder refilling appeared delayed in dyspeptic controls and mainly dependent on delayed gastric emptying in scleroderma. Small intestinal transit was also delayed in 74% of scleroderma and 66% of dyspeptic controls. Bowel habits were similar among the three groups. Autonomic neuropathy was not associated with dyspepsia, gastric and gallbladder motility and small intestinal transit. CONCLUSION In scleroderma patients dyspepsia (mainly gastric fullness), restricted distension of the gastric antrum and diffuse gastrointestinal dysmotility are frequent features. These defects are independent from the occurrence of autonomic neuropathy.
Collapse
Affiliation(s)
| | - Michele Covelli
- Department of Internal and Public Medicine (DIMIMP) University Medical School of Bari, Section of Rheumatology, Bari, Italy
| | - Massimo Berardino
- Department of Internal and Public Medicine (DIMIMP) University Medical School of Bari, Section of Internal Medicine, Bari, Italy
| | - David QH Wang
- Department of Medicine, Liver Center and Gastroenterology Division, Beth Israel Deaconess Medical Center, Harvard Medical School and Harvard Digestive Diseases Center, Boston, Massachusetts, USA
| | - Giovanni Lapadula
- Department of Internal and Public Medicine (DIMIMP) University Medical School of Bari, Section of Rheumatology, Bari, Italy
| | - Giuseppe Palasciano
- Department of Internal and Public Medicine (DIMIMP) University Medical School of Bari, Section of Internal Medicine, Bari, Italy
| | - Piero Portincasa
- Department of Internal and Public Medicine (DIMIMP) University Medical School of Bari, Section of Internal Medicine, Bari, Italy
| |
Collapse
|
6
|
Ekici A, Guliter S, Ekici M, Kalpaklioglu F, Kara T, Keles H, Tunckol M, Akin A, Kocyigit P. Irritable bowel syndrome in young and elderly patients with stable asthma. Dig Liver Dis 2005; 37:773-8. [PMID: 16023904 DOI: 10.1016/j.dld.2005.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2005] [Accepted: 05/25/2005] [Indexed: 02/06/2023]
Abstract
BACKGROUND It has been speculated that asthma and irritable bowel syndrome may share common pathophysiological processes. AIM To estimate the prevalence of irritable bowel syndrome in young and elderly patients with stable asthma. PATIENTS AND METHODS Sixty-five young (age < 60 years) and 66 elderly (age > or = 60 years) stable asthmatics, and 119 age-matched healthy volunteers were enrolled. In all participants, presence of irritable bowel syndrome, quality of life and psychological status were evaluated. RESULTS The prevalence of irritable bowel syndrome in asthmatic group was higher than that in the control group (27.5% versus 16.8%; odds ratio, 1.8 [1.0-3.4]; p=0.04). The prevalence of irritable bowel syndrome was significantly higher in young asthmatics than in age-matched healthy controls (36.9% versus 20.3%; odds ratio, 2.2 [1.0-5.1]; p=0.04) and than in elderly asthmatics (36.9% versus 18.2%; odds ratio, 0.3 [0.1-0.8]; p=0.01). Logistic regression analysis identified the younger age (odds ratio, 2.1 [1.1-3.8]; p=0.01), and the presence of asthma (odds ratio, 1.9 [1.0-3.5]; p=0.03) as independent risk factors for irritable bowel syndrome in all participants after adjusting for gender. We also found impaired quality of life to be associated with the presence of irritable bowel syndrome and asthma in all participants after adjusting for age and gender. CONCLUSION The prevalence of irritable bowel syndrome appears to be significantly higher in young asthmatics, but not in elderly asthmatics, compared to age-matched healthy counterparts. Potential pathogenic mechanisms of higher irritable bowel syndrome prevalence in young asthmatics need to be explained by further studies.
Collapse
Affiliation(s)
- A Ekici
- Kirikkale University, Faculty of Medicine, Department of Pulmonary Medicine, Ataturk Bulvari 9 Sok., Haci Mustafa Bey Apt. No: 2/2, 07100 Kirikkale, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|