PMID- 20424985
OWN - NLM
STAT- MEDLINE
DCOM- 20101005
LR  - 20211020
IS  - 1534-312X (Electronic)
IS  - 1522-8037 (Linking)
VI  - 12
IP  - 2
DP  - 2010 Apr
TI  - Sphincter of Oddi dysfunction.
PG  - 130-4
LID - 10.1007/s11894-010-0096-1 [doi]
AB  - Sphincter of Oddi dysfunction (SOD) is a poorly-understood disorder, typically 
      presenting as postcholecystectomy, "biliary-type," right-sided abdominal and/or 
      chest wall pain. Most patients referred to specialist clinics for work-up of 
      presumed SOD do not, in fact, have anything wrong with their bile ducts or 
      biliary sphincter mechanisms. A careful history and focused physical examination 
      will often identify the true source of the pain syndrome, ranging from chest wall 
      costochondritis and nerve injury at surgical trochar sites, to gastroparesis and 
      visceral hypersensitivity ("irritable bowel"). The Rome III classification of 
      functional gallbladder and biliary disorders defines SOD as episodic (not daily) 
      pain lasting more than 30 min, which is disruptive of normal activities and not 
      associated with bowel upset. It is not relieved by gastric acid suppression or 
      antispasmodics. Other causes of abdominal pain must be excluded. Standard work-up 
      includes endoscopic retrograde cholangiopancreatography (ERCP) with biliary 
      manometry, which risks post-ERCP pancreatitis, especially in young women with 
      normal bile ducts and liver serology. Noninvasive tests for SOD, such as timed 
      ("gated") cholecystokinin (CCK)-stimulated hepatobiliary iminodiacetic acid 
      (HIDA) scans and secretin-stimulated magnetic resonance cholangiopancreatography, 
      are imperfect and still evolving. Although many doubt the very existence of SOD, 
      a multidisciplinary approach to the management of pre- and postcholecystectomy 
      abdominal pain syndromes is long overdue.
FAU - Baillie, John
AU  - Baillie J
AD  - Section on Gastroenterology, Hepatobiliary and Pancreatic Disorders Service, Wake 
      Forest University Baptist Medical Center, Winston-Salem, NC 27157, USA. 
      jbaillie@wfubmc.edu
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Gastroenterol Rep
JT  - Current gastroenterology reports
JID - 100888896
SB  - IM
MH  - Chemoprevention/*methods
MH  - Cholangiopancreatography, Endoscopic Retrograde/*methods
MH  - Cholangiopancreatography, Magnetic Resonance/*methods
MH  - Cholecystectomy/*adverse effects
MH  - Diagnosis, Differential
MH  - Humans
MH  - Manometry
MH  - Pressure
MH  - Prognosis
MH  - *Sphincter of Oddi Dysfunction/diagnosis/etiology/prevention & control
MH  - Sphincterotomy, Endoscopic/*methods
RF  - 24
EDAT- 2010/04/29 06:00
MHDA- 2010/10/06 06:00
CRDT- 2010/04/29 06:00
PHST- 2010/04/29 06:00 [entrez]
PHST- 2010/04/29 06:00 [pubmed]
PHST- 2010/10/06 06:00 [medline]
AID - 10.1007/s11894-010-0096-1 [doi]
PST - ppublish
SO  - Curr Gastroenterol Rep. 2010 Apr;12(2):130-4. doi: 10.1007/s11894-010-0096-1.