Study Of Intestinal Motility In Patients With Acute Abdomen Using Phonography

The motor activity of the small and large bowel provides the needed function of the nonDaI digestion, absorption and transportation of intraluminal contents and excretion of wast products. This molor activity and consequently movement of the bowel is associated with special types of contractions which result in sound production.The motor activity of the bowel and hence bowel sounds usually affected by diseases and causes disturbance 0 f its normal pattern.Although the intestine is not like the heart as it does not show rhythmic regular typical pattern of contraction every minute. TIle more extensive study shows that it shows many types of regular cycles like migrating motor complex of the small intestine, around clock motility pattern of the colon, gastroileal rellex an the segmenting contraction which increase postprandially.Despite there is many methods and researches to intestinal rnotility, very few researches in the world since Cannon 1905 try to study intestinal sounds and found of il although intestinal sounds is the language by which the bowel always narrate about what it do second by second.Because simple auscultation does not give much information about bowel sounds and can not be recorded and quantified or compared, many trials have been done to use a good toal which covers this needs and also be sheap and easily applicable.Gumic & EL Sarafy developed a new method to record bowel sounds with the use of simple doppler apparatus connected to ECG machine to record events 011 ECG paper.Gumje & EL Sarafy compare the results of new method with the auscultatory character of sound and with some methods of detection of bow’c) motility in normal subjects and those with irritable bowel diseases and succeeded to numerate and characterize the waves reported in this cases.Our study is aiming to complete the standardization of this newly developed technique in other pathological state, which is the acute abdomen either due to surgical or medical problem.Our study has been done in 20 normal SUl)jects and 40 patients with acute abdomen due to surgical and medical problem.It is found that there is a big difference between flat period in normal state with a mean value of 23.55 ± 6.8 while it is about 4.66 ± 4.6 in a case of acute surgical abdomen and about 1.29 ± 3.41 in a case of acute abdomen due to medical problem.Also there is a big difference between the three cases in the oscillation period, the mean value was about 13.2 ± 4.54 in the nonnal state and about 51. 76 ± 6.4 in the acute surgical state, and about 36.7 ± 8.7 in the case of acute abdomen due to medical cause.No big differences was noticed between the mean value of the number of spike and bifid spike in normal case and those of acute abdomen due to medical problem as it was about 6.7 ± 4.1 and 2.45 ± 2.6 in the normal case and about 7 ± 6.4 and 3.18 ± 3.1 in the acute abdomen due to medical cause while the difference was big in the acute surgical case as it was 0.5 ± 0.8 and 0.1 ± 0.4 respectivelyOThere was also no big difference between the normal and acute abdomen due to medical cause in relation to small propulsion as the mean value in the first case was 6.35 ± 3.76 and it was 7054 ± 4.48 in the second one while in the surgical case it is significantly reduced to 1.03 ± 1.27 while in the great propulsion there was significantly increase in its mean value in a case 0 f acute abdomen due to medical cause as it was 3.36 ± 4.03 while in normal case was 0.9 ± 0.91 aDd acute surgical case was 0.25 ± 0.77While in post operative state the mean value of spike and bifid spike was greatly reduced to 0.1 and 0, and also small propulsion and large propulsion 0.18 ancl ° mean while there is significant increase of flat period 39 ±8 and oscillation 20.7 ± 7.8.It is well known previously that grave surgical illness and postoperative state is always associated with nearly silent abdomen and the acute abdominal pain of medical cause is associated with change character of bowel sound. However, in our extensive study of bowel sound, it is surprisingly to found that this silent surgical abdomen is associated with increase of the very small frequent sound numerated by us as oscillation. This can be assimilated as a so ill baby that his crying is continuous but inaudible mean while the acute abdomen due to medical cause is associated with change in the character of recorded waves. This can be assimilated as a baby who has been hurted so that he stopped singing and start crying but he is still strong to struggle and tell us about his problem.Our study and the consequent ones will put a big step in the methods of diagnosis of intestinal motility and more understail of bowel sounds.