cqvip:Ingestion of corrosive substances can lead to strictures of the esophagus and stomach. Cicatrization of the lower part of the esophagus can entrap vagal fibers in the process of fibrosis. The aim o f the present studywas to evaluate gallbladder dysfunction as a sequel to vagal damage in patients with corrosive-induced esophageal strictures. The cepha- lic phase of gallbladder emptying was stimulated by modified sham feeding acco rding to the chew-and-spit meth- od. Gallbladder volume was measured by ultrasonography using the ellipsoid met hod after an overnight fast and every 15 min for a period of 90min after sham fe eding in 22 patients and 10 controls. Mean fasting gallbladder volume was signif icantly greater in patients than in controls (22.09±9.78 vs. 14.61±4.42 ml; P = 0.025). After sham feeding the gallbladder ejection fraction was significantly lower in patients than in controls(32.86±17.21 vs. 49.40±7.86%; P = 0.007).P atients with cicatrization in the distal one-third of the esophagus had a great er basal gallbladder volume (24.57±9.2 ml) and significantly lower ejection fra ction (20.47±8.9%) than patients with strictures at other sites (gallbladder v olume, 18.50±10.69 ml; ejection fraction, 47.48±13.3%; P=0.001). In conclusio n,patients with corrosive-in d- uced esophageal strictures,especially those in the distal one-third, had an i ncreased fasting gallbladder volume and decreased cephalic phase of gallbladder emptying, pointing to impaired vagal cholinergic transmission,possi- bly due to vagal entrapment in the cicatrization process.
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