Arrigo Raia

Motility of the sigmoid colon and rectum

SummaryThe motility of the sigmoid colon and rectum was studied by electromanometry in normal subjects and in patients with chagasic megacolon before and 2.5 to 3.5 years after treatment by abdomino-endoanal rectosigmoidectomy. The study was with the subjects at rest and after injection of methacholine chloride.Records of normal subjects showed minimal activity with a preponderance of simple waves of low amplitude and short duration, the sigmoid and rectum exhibiting independent activities during the major period of observation. Patients with chagasic megacolon, both before and after surgical treatment, had hyperactivity, with more numerous waves of higher amplitude and longer duration. They also had greater proportions of complex waves, and activities of the two segments of colon studied were synchronous.In normal subjects, methacholine chloride did not alter the motor activity of the sigmoid and rectum. In patients with chagasic megacolon, both before and after operation, methacholine chloride increased motor activity in both segments.All abnormalities in colonic motor activity of patients with chagasic megacolon were considered to result from the lesions of the ganglion cells of the intestinal myenteric plexus always present in this disease.

The dynamics of the main biliary duct and the mechanism of the biliopancreatic reflux

ConclusionsThe terminal portion of the bile duct (the bile-duct sphincter) and the musculature of the ampulla contract together.A functional autonomy of the sphincter of Oddi is rarely observed.A choledochoduodenal synergy was noted in each case. The spasm of Oddis sphincter is synchronous with duodenal spasm.Pancreatic reflux occurs with pressure levels varying from 12 to 50 cm. of saline solution. A fatty meal may hinder the reflux in the pancreatic duct in individuals without biliary disease.