Sphincter of Oddi Physiology
Sphincter of Oddi Physiology
Sphincter of Oddi Physiology
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Paradoxical Motor Response to CCK inPatients With Suspected SO Dysfunction(SO manometric recording)*SO Rapid Phasic Wave ActivityBasal SOPressure(mmHg)200180160140[ ]5 <strong>of</strong> 38 pts suspected SOD21 controls pts120100 CCK80 20 ng/kg IV60402000 30 60 90 120 150[Time in seconds]* [Hogan, et al. Gastroenterology 1980; 78:317-324]Elevated SO Basal PressureBiliary <strong>Sphincter</strong>mmHgSO Dysfunction• Structural alteration –(SO Stenosis)• Functional Abnormalities –(So Dysfunction)• Criteria: Abnormal Basal SOP± Response to smooth muscle relaxant<strong>Sphincter</strong> <strong>of</strong> <strong>Oddi</strong> Dysfunction (SOD)Modified Milwaukee ClassificationBiliaryTypeBiliaryPainLFTAbn.DilatedCBD >10 mmEtiologySten vs DyskType 1 + + + +Type II + 1 or 2 <strong>of</strong> above + +Type III + None <strong>of</strong> above +[Hogan, Geenen. Endoscopy 1998;1:179]
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