Pancreatic Sphincter of Oddi Dysfunction

Jimin Han; Ho Gak Kim

doi:10.4166/kjg.2009.53.6.333

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Han and Kim: Pancreatic Sphincter of Oddi Dysfunction

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Korean J Gastroenterol 2009;53(6):333-335.

Published online: 21 February 2009

DOI: https://doi.org/10.4166/kjg.2009.53.6.333

Pancreatic Sphincter of Oddi Dysfunction

Jimin Han, M.D., Ho Gak Kim, M.D.

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea

Correspondence to: Ho Gak Kim, M.D. Department of Internal Medicine, Catholic University of Daegu School of Medicine, 3056-6, Daemyeong 4-dong, Nam-gu, Daegu 705-718, Korea Tel: +82-53-650-4041, Fax: +82-53-624-3281 E-mail: hgkim@cu.ac.kr

REFERENCES

1. Behar J, Corassiari E, Guelrud M, Hogan W, Sherman S, Toouli J. Functional gallbladder and sphincter of Oddi disorders. Gastroenterology. 2006; 133:1498–1509.

2. Toouli J, Di Francesco V, Saccone G, Kollias J, Schloithe A, Shanks N. Division of the sphincter of Oddi for treatment of dysfunction associated with recurrent pancreatitis. Br J Surg. 1996; 83:1205–1210.

3. Tarnasky PR, Palesch YY, Cunningham JT, Mauldin PD, Cotton PB, Hawes RH. Pancreatic stenting prevents pancreatitis after biliary sphincterotomy in patients with sphincter of Oddi dysfunction. Gastroenterology. 1998; 115:1518–1524.

4. Elton E, Howell DA, Parsons WG, Qaseem T, Hanson BL. Endoscopicpancreatic sphincterotomy: indications, outcome and a safe stentless technique. Gastrointest Endosc. 1998; 47:240–249.

5. Mariani A, Curioni S, Zanello A, et al. Secretin MRCP and endoscopic pancreatic manometry in the evaluation of sphincter of Oddi function: a comparative pilot study in patients with idiopathic recurrent pancreatitis. Gastrointest Endosc. 2003; 58:847–852.

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Fig. 1.

Contrast-enhanced CT finding of the patient. Pancreas was normal looking without edema, peripancreatic infiltration, or fluid collection.

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Fig. 2.

Endoscopic retrograde cho-langiopancreatography findings. (A) Major duodenal papilla looked normal. (B) Pancreatogram showed unremarkable finding. (C) Sphincter of Oddi manometry was performed with a catheter placed in-side the main pancreatic duct. (D) After withdrawal of the manometry device, pancreatic stent (5Fr 3 cm) was placed.

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Fig. 3.

Sphincter of Oddi manometry finding. Basal pressure of pancreatic sphincter was higher than 40 mmHg, which was diagnostic of sphincter of Oddi dysfunction. Frequent tonic con-tractions were seen. The highest altitude was 502 mmHg.

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Fig. 4.

Endoscopic treatment with pancreatic sphincterotomy. (A) Using a pull-type papillotome, pancreatic sphincter was cut. (B) Pancreatic duct orifice was exposed after pancreatic sphincterotomy.

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