P0231 - Minimizing Colonic Manometry Catheter Migration

Omar Brijawi, MD¹, Lev Dorfman, MD², Khalil El-Chammas, MD, MS², Ajay Kaul, MD^2
1Mount Carmel Health System, Grove City, OH; ²Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Introduction: Colonic manometry (CM) is a diagnostic procedure used to evaluate pediatric patients with refractory constipation. Colonic catheter dislodgement is a major concern, limiting CM studies and sometimes causing them to be aborted. Several methods are implemented to reduce catheter displacement including strict bed rest, avoidance of feeding and securing manometry catheter tip with an endoclip.

We aimed to determine the factors affecting colonic manometry catheters displacement.

Methods: We evaluated CM studies conducted at a tertiary pediatric center over three years. Data collected included demographics, co-morbidities, indication for colonic manometry, number of clips used, imaging and colonic manometry findings. Manometry catheter dislodgement was evaluated by abdominal x-rays performed prior to each study initiation.

Results: A total of 241 studies met inclusion criteria, with 118 (49%) females and a median age of 9.9 years (IQR 6.1-13.6). Catheter displacement was noted in 56 (23.2%) with 13 (5.4%) of catheters being dislodged distally in the same colonic segment and 43 (84.3%) of them dislodging distally over at least one segment.

Catheter tips clipped with 1 clip had significantly higher rate of distal dislodgment compared to catheters secured with 2 clips (11.1% vs. 26.7%. p=0.017). On a multiple logistic regression of catheter displacement, adjusted for age, sex, manometry findings and comorbidities, use of 1 clip had 3.1 higher odds of displacement, compared to using 2 clips (p=0.016).

The initial clip location in the colon, age, colonic manometry findings, and comorbidities were not significantly different among studies with and without catheter displacement. No adverse events were noted with placement of either one or two clips.

Discussion: Securing the tip of the manometry catheter with two endoclips proved more effective than using a single endoclip, significantly reducing distal catheter dislodgement without increasing side effects. Dislodgement of colonic catheter was not impacted by any demographic feature or comorbidity studied.



Disclosures:


Omar Brijawi, MD¹, Lev Dorfman, MD², Khalil El-Chammas, MD, MS², Ajay Kaul, MD². P0231 - Minimizing Colonic Manometry Catheter Migration, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.