Skip to main content

Advertisement

Log in

A study of intragastric and intravesicular pressure changes during rest, coughing, weight lifting, retching, and vomiting

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

In patients undergoing a variety of procedures, surgical success is in part dependent on maintaining normal intra-abdominal pressure in the immediate postoperative period. Our objective was to quantify intragastric and intravesicular pressures during activities, through the use of manometry catheters.

Methods

Ten healthy volunteers had a manometry catheter placed transnasally, and a urinary Foley catheter placed. Baseline intragastric and intravesicular pressures were recorded and the catheters were then transduced continuously. Pressures were recorded with activity: coughing, lifting weights, retching (dry heaving), and vomiting.

Results

All pressure changes were significant from baseline except for weight lifting. The highest intragastric pressure was 290 mmHg, seen during vomiting. Comparison of intragastric and intravesicular pressures showed no significant difference. There was significantly higher intragastric pressure with vomiting and retching as compared with coughing, whereas coughing applied more pressure than weight lifting.

Conclusions

This is the first report of intragastric pressures during vomiting and retching (dry heaving). We conclude that vomiting and retching (dry heaving) can render significant forces on any tissue apposition within the stomach or the peritoneal cavity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Iqbal A, Kakarlapudi GV, Awad ZT, Haynatzki G, Turaga KK, Karu A, Fritz K, Haider M, Mittal SK, Filipi CJ (2006) Assessment of diaphragmatic stressors as risk factors for symptomatic failure of laparoscopic Nissen fundoplication. J Gastrointest Surg. 10(1):12–21

    Article  PubMed  Google Scholar 

  2. Schein M, Wittmann DH, Aprahamian CC, Condon RE (1995) The abdominal compartment syndrome the physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg 180:745–753

    PubMed  CAS  Google Scholar 

  3. Fusco MA, Martin RS, MC Chang (2001) Estimation of intra-abdominal pressure by bladder pressure measurement validity and methodology. J Trauma 50:297–302

    Article  PubMed  CAS  Google Scholar 

  4. Iberti TJ, Lieber CE, Benjamin E (1989) Determination of intra-abdominal pressure using a transurtethral bladder catheter: clinical validation of the technique. Anesthesiology 70(1):47–50

    Article  PubMed  CAS  Google Scholar 

  5. Gudmundsson FF, Viste A, Gislason H, Svanes K (2002) Comparison of different methods for measuring intra-abdominal pressure. Intensive Care 28(4):389–391

    Article  Google Scholar 

  6. Sugrue M, Buist MD, Lanchez LA, Sanchez DJ, Hillman KM (1994) Intra-abdominal pressure measurement using a modified nasogastric tube: description and validation of a new technique. Intensive Care Med 20(8):588–590

    Article  PubMed  CAS  Google Scholar 

  7. Collee GG, Lomax DM, Ferguson C, Hanson GC (1993) Bedside measurement of intra-abdominal pressure (IAP) via an indwelling naso-gastric tube: clinical validation of the technique. Intensive Care Med 19(8):478–480

    Article  PubMed  CAS  Google Scholar 

  8. Mayberry JC, Goldman RK, Mullins RJ, Brand DM, Crass RA, Trunkey DD (1999) Surveyed opinion of American trauma surgeons on the prevention of the abdominal compartment syndrome. J Trauma 47:509–513

    PubMed  CAS  Google Scholar 

  9. Overholt RH (1931) Intraperitoneal pressure. Arch Surg 22:691

    Google Scholar 

  10. Iberti TJ, Kelly KM, Gentili DR, Hirsch S, Benjamin E (1987) A simple technique to accurately determine intra-abdominal pressure. Crit Care Med 15:1140–1142

    Article  PubMed  CAS  Google Scholar 

  11. Kashtan J, Green JF, Parsons EQ, Holcroft JW (1981) Hemodynamic effect of increased abdominal pressure. J Surg Res 30:249–255

    Article  PubMed  CAS  Google Scholar 

  12. Junge K, Klinge U, Prescher A, Giboni P, Niewiera M, Schumpelick V (2001) Elasticity of the anterior abdominal wall and impact for reparation of incisional hernias using mesh implants. Hernia 5:113–118

    Article  PubMed  CAS  Google Scholar 

  13. Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias nine years’ experience with 850 consecutive hernias. Ann Surg 238:399–400

    Google Scholar 

  14. Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:583–585

    Google Scholar 

  15. Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398

    Article  PubMed  CAS  Google Scholar 

  16. Klinge U, Conze J, Klosterhalfen B, Limberg W, Obolenski B, Ottinger AP, Schumpelick V (1996) Changes in abdominal wall mechanics after mesh implantation. Experimental changes in mesh stability. Langenbecks Arch Chir 381:323–332

    Article  PubMed  CAS  Google Scholar 

  17. Ramshaw B, Abiad F, Voeller G, Wilson R, Mason E (2003) Polyester (Parietex) mesh for total extraperitoneal laparoscopic inguinal hernia repair initial experience in the United States. Surg Endosc 17:498–501

    Article  PubMed  CAS  Google Scholar 

  18. Klinge U, Klosterhalfen B, Conze J, Limberg W, Obolenski B, Ottinger AP, Schumpelick V (1998) Modified mesh for hernia repair that is adapted to the physiology of the abdominal wall. Eur J Surg 164:951–960

    Article  PubMed  CAS  Google Scholar 

  19. Oyogoa S, Komenaka I, Wise L (2000) Vertical banded gastroplasty staple-line dehiscence after blunt trauma to the abdomen. Obes Surg 10(1):61–63

    Article  PubMed  CAS  Google Scholar 

  20. Kalfarentzos F, Kechagias I, Soulikia K, Loukidi A, Mead N (2001) Weight loss following vertical banded gastroplasty: intermediate results of a prospective study. Obes Surg 11(3):265–270

    Article  PubMed  CAS  Google Scholar 

  21. Ikeda K, Fritscher-Ravens A, Mosse C, Mills T, Tajiri H, Swain CP (2005) Endoscopic full-thickness resection with sutured closure in a porcine model. Gastrointest-Endosc 62(1):122–129

    Article  PubMed  Google Scholar 

  22. Mairiaux P, MalchaireJ Vandiepenbeeck D, Bellelahom L (1988) Reproducibility of intra-abdominal pressure when lifting. Scand J Rehabil Med 20(2):83–88

    PubMed  CAS  Google Scholar 

  23. Cobb WS, Burns JM, Kercher KW, Matthews BD, James Norton H, Todd Heniford B (2005) Normal intraabdominal pressure in healthy adults. J Surg Res 129(2):231–235

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Sue Corkell, R.N., our volunteers, and all the staff at the Esophageal Center at Creighton University School of Medicine for their help in obtaining and quantifying the data presented.

Grant support: Ethicon Endo-Surgery, 4545 Creek Road, Cincinnati, Ohio 45242-7000, USA.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Charles J. Filipi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Iqbal, A., Haider, M., Stadlhuber, R.J. et al. A study of intragastric and intravesicular pressure changes during rest, coughing, weight lifting, retching, and vomiting. Surg Endosc 22, 2571–2575 (2008). https://doi.org/10.1007/s00464-008-0080-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-0080-0

Keywords

Navigation