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Biliary Sphincter of Oddi Dysfunction.

Asim Haider1, Ayesha Siddiqa1, Nisha Ali1

  • 1Internal Medicine, BronxCare Health System, Bronx, New York, USA.

Case Reports in Gastroenterology
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Summary
This summary is machine-generated.

Sphincter of Oddi dysfunction (SOD) is a treatable condition causing abdominal pain. Endoscopic treatment relieved symptoms and normalized liver tests in a post-cholecystectomy patient.

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Area of Science:

  • Gastroenterology and Hepatology
  • Interventional Endoscopy

Background:

  • Sphincter of Oddi dysfunction (SOD) is a complex condition characterized by impaired function of the sphincter of Oddi, leading to biliary or pancreatic symptoms.
  • It is classified into biliary and pancreatic types based on clinical presentation and diagnostic findings.
  • Post-cholecystectomy patients can develop or present with SOD, complicating their clinical course.

Observation:

  • A 51-year-old female, status post-cholecystectomy, presented with chronic, intermittent right upper quadrant pain.
  • Investigations revealed persistently elevated liver function tests and a dilated common bile duct, with no evidence of choledocholithiasis.
  • Endoscopic retrograde cholangiopancreatography (ERCP) with manometry confirmed elevated sphincter of Oddi pressure, establishing the diagnosis of SOD.

Findings:

  • The diagnostic ERCP procedure was followed by therapeutic endoscopic sphincterotomy and papillotomy.
  • Following the intervention, the patient experienced normalization of liver function tests.
  • Resolution of her chronic right upper quadrant pain was achieved post-procedure.

Implications:

  • Endoscopic sphincterotomy is an effective treatment for confirmed Sphincter of Oddi dysfunction in post-cholecystectomy patients.
  • This intervention can successfully alleviate debilitating symptoms and normalize liver biochemistry.
  • Accurate diagnosis and timely endoscopic management are crucial for improving patient outcomes in SOD.