COMMENTARY

Sphincter of Oddi dysfunction

Prospective comparison of secretin-stimulated MRCP with manometry in the diagnosis of sphincter of Oddi dysfunction types II and III

John Baillie¹, James Kimberly²

¹ Hepatobiliary and Pancreatic Disorders Service, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA
² Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, USA

Correspondence to:
Correspondence to:
Dr J Baillie
Section of Gastroenterology, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA;jbaillie@wfubmc.edu

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Is the role of secretin in causing a choleresis clinically significant enough to be a "stress test" for biliary SOD?

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The first 150 words of the full text of this article appear below.

Every specialty in Medicine has its orphan diagnosis; in ophthalmology it’s "dry eyes", in gynaecology "dyspareunia", in rheumatology "fibromyalgia" and the list goes on. In gastroenterology, the vast diagnostic and therapeutic wasteland is irritable bowel syndrome (IBS). However, deep within IBS (or more correctly, chronic functional abdominal pain syndrome) there is an almost impenetrable jungle, called sphincter of Oddi Dysfunction (SOD). It is not a place for the faint-hearted. SOD as a fashionable diagnosis first appeared on the radar screen in a 1989 N Engl J Med paper: a group of US investigators published their experience of endoscopic (biliary) sphincterotomy (EBS) in patients with postcholecystectomy pain.¹ The authors divided SOD into three categories depending on the presence or absence of transiently abnormal liver serologies and/or common bile duct (CBD) dilatation. "Typical" biliary-type pain was needed to make the SOD diagnosis. Type I patients had "typical" biliary . . . [Full text of this article]

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Prospective comparison of secretin-stimulated magnetic resonance cholangiopancreatography with manometry in the diagnosis of sphincter of Oddi dysfunction types II and III

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