Diagnosis and management of sphincter of Oddi dysfunction and pancreas divisum

Sphincter of Oddi dysfunction and pancreas divisum are very distinct anatomic abnormalities, yet are diagnosed in similar clinical situations. While both entities are uncommon, they are most often discovered during the evaluation of postcholecystectomy syndrome, recurrent idiopathic pancreatitis, and biliary or pancreatic pain when first line studies are normal. Treatment consists of surgical sphincteroplasty or endoscopic sphincterotomy for both diagnoses, which result in reliable relief of symptoms for most sphincter of Oddi dysfunction patients but less predictable response in pancreas divisum.