[Primary odditis. Clinical features, therapy, and possible pathogenesis (author's transl)]

Primary odditis, a rare affection, was observed in 28 patients (15 women and 13 men) with a mean age of 56.4 years. Epigastric or right hypochondrial pain was the presenting symptom in 13 cases, while in 13 others the onset was heralded by jaundice, either of a chronic nature (2 cases) or of the pseudo-lithiasic type (11 cases). The pancreatic form is much less frequent (2 cases). Radiological and histological findings are compared with those described in the published literature. All patients demonstrated a specific psychosomatic profile. Primary odditis can be reproduced experimentally in dogs by chronic irritation of the right splanchnic nerve, this acting on a nerve circuit which includes the right splanchnic and left vagus nerves. It is suggested that such lesions are secondary to a "nervous irritation" (Reilly's phenomenon). Treatment of primary odditis is by surgery only, sphincterectomy giving the best results, though choledochoduodenal anastomosis is also effective in elderly patients.