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Colegio de Medicos y Cirujanos República de Costa Rica

2015, Number 614

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Rev Med Cos Cen 2015; 72 (614)

Disfunción del esfínter de Oddi

Muñoz JG

Language: Spanish
References: 12
Page: 183-188
PDF size: 180.85 Kb.


ABSTRACT

The sphincter of Oddi (SOD) is a functional gastrointestinal disorder that manifests as a syndrome of chronic biliary pain or recurrent pancreatitis due to obstruction of the flow at pancreaticobiliary sphincter of Oddi. Milwaukee classification groups patients according to their clinical picture based on elevated liver enzymes, dilated common bile duct and the presence of abdominal pain. Type I are patients who have pain and abnormal liver enzymes, and a dilated common bile duct. Type II consists of pain and a single objective and type III consists of only finding biliary pain. This classification is useful to guide the diagnosis and treatment of sphincter of Oddi dysfunction. The current gold standard for diagnosis is manometry to detect elevated sphincter pressure, however, manometry is not widely available and is an invasive procedure that can lead to an increased risk of pancreatitis. Biliary dynamic scintigraphy has been used as a noninvasive tool to assess the sphincter of Oddi, providing indirect evidence of increasing resistance of the sphincter. In this review, an analysis of the current evidence on the issue, with special emphasis on the current diagnosis and treatment of patients with sphincter of Oddi dysfunction and considering that manometry is unavailable.


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