Sphincter of Oddi dysfunction and acute pancreatitis

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Abstract
Normal human SO motility has been characterised by a number of studies and normal manometric parameters have been established using standardised manometry, as has SO dysfunction. The clinical presentation of patients with SO dysfunction may be divided into two groups: biliary SO dysfunction presenting with biliary type pain; and recurrent pancreatitis.2 In 1995, the following definition of SO dysfunction was developed: “partial obstruction of the SO biliary segment giving rise to intermittent, episodic upper abdominal pain, deranged liver function tests, dilatation or delayed drainage of injected contrast from the common bile duct. Likewise, similar condition of the pancreatic segment can give rise to pancreatitis or episodic pain suggesting a pancreatic origin”.3 The main consequence of SO dysfunction is impedance of bile and pancreatic juice flow, either through a structural stenosis or functional stenosis from hypertonia. In some instances, however, hypotonia as a result of dyskinesia may also occur and reflect SO dysfunction.