Sphincter of Oddi dysfunction (SOD) refers to a motor abnormality of the sphincter of Oddi, typically resulting in a hypertonic sphincter, and may be manifested clinically by chronic abdominal pain, pancreatitis, or abnormal liver function tests. In this chapter, we discuss the classification systems typically used in SOD, as well as the epidemiology of this controversial disease. The diagnostic criteria for SOD and appropriate evaluation of patients are reviewed. Both non-invasive and invasive diagnostic methods are discussed. Sphincter of Oddi manometry (SOM) is the only available method to measure motor activity directly, and is considered currently to be the diagnostic gold standard. Indications, performance, and complications of this technique are reviewed. Therapy for SOD is discussed, using an evidence-based approach.
- Endoscopic ultrasound monitoring
- Morphine-prostigmin provocative test (nardi test)
- Serum chemistries
- Sphincter of oddi dysfunction (SOD)
- Standard imaging
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