Here's one for the Sphincter of Oddi fans out there . . .

[Guest guest]

Well, fellow travelers, here is one that talks specifically about

Sphincter of Oddi. Don't know much about this myself and am not sure

how much information there is that is relevant.

Sphincter of Oddi (pancreatic) hypertension and recurrent pancreatitis.

Devereaux BM, Sherman S, Lehman GA.

Indiana University Medical Center, 550 North University Boulevard,

Suite 2300, Indianapolis, IN 46202, USA.

Major papilla pancreatic sphincter dysfunction, a variant of

sphincter of Oddi dysfunction, causes pancreatitis and pancreatic-

type pain. The gold standard for diagnosis is sphincter of Oddi

manometry, most commonly performed at endoscopic retrograde

cholangiopancreatography (ERCP). Noninvasive testing, such as

secretin-stimulated transabdominal or endoscopic ultrasound

assessment of pancreatic duct diameter, is less reliable and has

relatively low sensitivity. Two thirds of patients with biliary

sphincter of Oddi dysfunction have elevated pancreatic basal

sphincter pressure. To maximize the diagnostic yield of sphincter of

Oddi dysfunction, both the biliary and pancreatic sphincter pressures

should be measured. Patients with sphincter of Oddi dysfunction may

respond to biliary sphincterotomy alone, but evaluation of their

pancreatic sphincter is warranted if symptoms persist after biliary

therapy alone. Whether both biliary and pancreatic sphincters should

be treated at the first ERCP session is controversial. Biliary and

pancreatic endoscopic sphincterotomies are associated with two- to

fourfold increased incidence of pancreatitis following the procedure

in patients with pancreatic sphincter hypertension. Prophylactic

pancreatic duct stenting reduces the frequency and severity of

complications by greater than 50%.

Publication Types:

Review

PMID: 11900681 [PubMed - indexed for MEDLINE]

Anyse