Sphincter of Oddi dysfunction

From Wikipedia, the free encyclopedia - View original article

Sphincter of Oddi dysfunction
Classification and external resources

A diagram of the biliary tree showing the sphincter of Oddi. Note that part of the gall bladder has been removed, and the liver has been lifted off the tree.
ICD-9576.5
MeSHD046628
 
Jump to: navigation, search
Sphincter of Oddi dysfunction
Classification and external resources

A diagram of the biliary tree showing the sphincter of Oddi. Note that part of the gall bladder has been removed, and the liver has been lifted off the tree.
ICD-9576.5
MeSHD046628
Digestive system diagram showing the common bile duct (note that the sphincter of oddi is not labelled

Sphincter of Oddi dysfunction refers to two motility conditions affecting the Sphincter of Oddi; papillary stenosis and sphincter of Oddi dyskinesia (also known as biliary dyskinesia). The sphincter of Oddi is a sphincter muscle, a circular band of muscle at the bottom of the biliary tree which controls the flow of pancreatic juices and bile into the second part of the duodenum. Both types of dysfunction can obstruct flow through the sphincter of Oddi and can therefore cause retention of bile in the biliary tree and pancreatic juice in the pancreatic duct.

Sphincter of Oddi dysfunction is a rare condition[citation needed]. However, as with most conditions, certain factors make it more likely, such as patients with biliary-pancreatic disease[1]. Attacks can be precipitated by opioid analgesics [2], particularly in patients having undergone cholecystectomy (gall bladder removal) or have had bariatric surgery (Gastric Bypass or weight loss surgery).

Contents

Presentation

Sphincter of Oddi dysfunction may be suggested by pain which seems to come from a biliary origin, which may or may not be associated with transient increases of liver or pancreatic enzymes. Common bile duct dilation and episodes of pancreatitis are also signs.[3]

Diagnosis

For diagnosis, measures of liver biochemistry and pancreatic enzymes are performed. Along with ruling out structural abnormalities, normally by performing an abdominal ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). Measurements of bile transit when performing ERCP are taken to help evaluate different treatment options.[3]

Treatment

Sphincter of Oddi manometry or Sphincterotomy are the standard treatments for sphincter of Oddi dysfunction. One or the other may be better based on the classification of the condition.

Forms

Papillary Stenosis

Sphincter of Oddi dyskinesia

Also known as Biliary dyskinesia

See also

References

  1. ^ Rodrigues, R.; Libera, E.; Guimaraes, A.; Ferrari, A.; Geocze, S. (2004). "High Prevalence of Sphincter of Oddi Dysfunction in Patients with Biliary-Pancreatic Disease Referred to Endoscopic Retrograde Cholangiopancreatography". Gastrointestinal Endoscopy 59 (5): P192–P195. doi:10.1016/S0016-5107(04)00894-6.  edit
  2. ^ http://www.anzca.edu.au/fpm/events/fpm-events/1-CBell.pdf
  3. ^ a b Corazziari, E. (2003). "Sphincter of Oddi dysfunction". Digestive and Liver Disease 35: 26–23. doi:10.1016/S1590-8658(03)00090-2.  edit

External links