Table 4. Agreement of high-resolution manometry (HRM) and FLIP Panometry assessment of EGJ obstruction and association with barium esophagram.
4A. The frequency agreement of EGJ outflow obstruction on HRM, defined by integrated relaxation pressure (IRP) with the FLIP Panometry classification of EGJ opening are displayed relative to timed barium esophagram (TBE) results. 4B. The HRM classifications among HRM-FLIP Panometry concordant cases and discordant cases are displayed relative to TBE results. Abnormal TBE was defined as a 1 minute column height >5cm or inability of a 12.5mm tablet to pass. Concordance with FLIP EGJ opening and HRM-IRP are shaded blue; discordance is shaded red.
| 4A | ||||
|---|---|---|---|---|
| Abnormal TBE (n, % total abnormal TBE) | ||||
| REO | BEO | NEO | Total | |
| Consistent IRP elevation | 123 (57) | 24 (11) | 6 (3) | 153 (71) |
| Isolated IRP elevation | 18 (8) | 7 (3) | 1 (1) | 26 (12) |
| Normal IRP | 11 (5) | 12 (6) | 13 (6) | 36 (17) |
| Total | 152 (71) | 43 (20) | 20 (9) | 215 (100) |
| /// /// /// /// /// /// /// /// /// /// /// /// | ||||
| Normal TBE (n, % total normal TBE) | ||||
| REO | BEO | NEO | Total | |
| Consistent IRP elevation | 6 (5) | 8 (7) | 20 (18) | 34 (30) |
| Isolated IRP elevation | 2 (2) | 11 (10) | 11 (10) | 24 (21) |
| Normal IRP | 3 (3) | 16 (14) | 37 (33) | 56 (49) |
| Total | 11 (10) | 35 (31) | 68 (60) | 114 (100) |
| 4B | ||||
|---|---|---|---|---|
| Abnormal TBE | ||||
| Concordant results | Discordant results | |||
| Consistent IRP elevation + REO |
Normal IRP + NEO |
Consistent IRP elevation + NEO |
Normal IRP + REO |
|
| n (%) | n (%) | n (%) | n (%) | |
| HRM-Chicago Classification v4.0 | ||||
| Type I achalasia | 20 (16) | 0 | 1 (17)* | 0 |
| Type II achalasia | 58 (47) | 0 | 0 | 0 |
| Type III achalasia | 15 (12) | 0 | 0 | 0 |
| EGJ outflow obstruction | 30 (24) | 0 | 3 (50) | 0 |
| Hypercontractile esophagus | 0 | 1 (8) | 0 | 0 |
| Distal esophageal spasm | 0 | 1 (8) | 0 | 1 (9) |
| Absent contractility | 0 | 4 (31) | 0 | 4 (36) |
| Ineffective esophageal motility | 0 | 2 (15) | 0 | 2 (18) |
| Normal motility | 0 | 5 (39) | 2 (33) | 4 (36) |
| /// /// /// /// /// /// /// /// /// /// /// /// | ||||
| Normal TBE | ||||
| Concordant results | Discordant results | |||
| Consistent IRP elevation + REO |
Normal IRP + NEO |
Consistent IRP elevation + NEO |
Normal IRP + REO |
|
| n (%) | n (%) | n (%) | n (%) | |
| HRM-Chicago Classification v4.0 | ||||
| Type I achalasia | 0 | 0 | 0 | 0 |
| Type II achalasia | 0 | 0 | 0 | 0 |
| Type III achalasia | 1 (17) | 0 | 0 | 0 |
| EGJ outflow obstruction | 3 (50) | 0 | 14 (70) | 0 |
| Hypercontractile esophagus | 0 | 0 | 0 | 0 |
| Distal esophageal spasm | 0 | 0 | 0 | 0 |
| Absent contractility | 0 | 3 (8) | 0 | 0 |
| Ineffective esophageal motility | 0 | 4 (11) | 2 (10) | 1 (33) |
| Normal motility | 2 (33) | 30 (81) | 4 (20) | 2 (2) |
*
This patient had systemic sclerosis and a patulous appearing EGJ and barium retention on TBE. REO – reduced EGJ opening; BEO – borderline EGJ opening; NEO – normal EGJ opening