Chronic splanchnic ischaemia: is tonometry a useful test?

OBJECTIVE

To find out if gastric tonometry is of sufficient accuracy to diagnose chronic splanchnic syndrome.

DESIGN

Prospective open study.

SETTING

University hospital, The Netherlands.

SUBJECTS

10 patients in whom chronic splanchnic syndrome had been suspected, and in 5 of whom it was subsequently confirmed.

INTERVENTION

Standardised measurement of intramucosal gastric pH (tonometry) and multiplane angiography of the abdominal aorta and splanchnic arteries.

MAIN OUTCOME MEASURE

Correlation between intramucosal gastric pH and angiographic and clinical findings.

RESULTS

The mean basal pH preoperatively was 7.48 among 5 patients subsequently found to have splanchnic syndrome (group 1) and 7.41 among the 5 who did not (group 2). Those in group 1 all had extensive three vessel disease with stenoses of 70% or more in at least two of the three splanchnic arteries. The 5 patients in group 2 had no clinically important stenoses in either the coeliac or the superior mesenteric artery; 4 had occlusions of the inferior mesenteric artery.

CONCLUSION

Gastric tonometry is of no use in the diagnosis of chronic splanchnic syndrome.