The Use of High Resolution Manometry in the Management of a Patient with Dysphagia Secondary to Laparoscopic Adjustable Gastric Band - A Case Study - Abstract
A 46-year-old obese woman presented to the Gastroenterology clinic with symptoms of dysphagia, odynophagia, regurgitation and vomiting. She had a laparoscopic adjustable gastric band in situ for a period of 10 years and this was believed to be causing her troublesome symptoms. Barium swallow indicated a hold up of contrast at the esophago-gastric junction and in the gastric reservoir between the junction and the band. High Resolution Manometry could confirm the placement of the band and the dual high pressure zones of the esophago-gastric junction and the gastric band. An elevated Integrated Resting Pressure and intra-bolus pressure indicated a hold up of bolus and resistanceto flow across the esophago- gastric junction and in the gastric reservoir. 12 months post laparoscopic band removal, High Resolution Manometry was repeated. This revealed normalesophageal motility, a relaxing esophago-gastric junction and normal bolus transit. The patient’s symptoms improved greatly however her weight gain continued to be the cause ofmuch stress to her and her options are under review. High Resolution Manometry is a useful tool in the assessment of patients with complicated gastric bands and is recommended both pre and post band placement or removal.