Spincter of oddi manometry (SOM) in patients clinically suspected of sphincter of oddi dysfunction (SOD)

Spincter of oddi manometry (SOM) in patients clinically suspected of sphincter of oddi dysfunction (SOD)

Bancha Ovartlarnporn, Assoc. Prof., D. of Internal Medicine, F. of Medicine, PSU.
Parinya Suntharaponchai, Asst. Prof., D. of Surgery, F. of Medicine, PSU.
Teerha Piratvisuth, Assoc. Prof., D. of Internal Medicine, F. of Medicine, PSU.
Noppawan Osatakul, Nurse, D. of Surgery, F. of Medicine, PSU.
Corresponding e-mail : ptimmy@ratree.psu.ac.th

Published : J Gastroenterol Hepatol, 1999 14(Suppl.) S110 Key words : spincter of oddi manometry, SOD

SOD is one of the etiologies encountered in patients presented with pancreatitis, postchole-cystectomy pain (EP) of unexplained nature.

Aim : To report our experience of SOM in patients presented with unexplained pancreatitis, PP and EP.

Methods : SOM's were done in 18 patients from October 1993 to March 1999. At least 2 recordings of the sphincter of Oddi were obtained. The basal pressure (BP) > 40 mmHg was defined as abnormal.

Results : There were 5 males 13 females with the mean age ą SD of 49.72ą17.33 and a range of 25-82 years. Clinical presentation included 11 EP, 2 unexplained pancreatitis and 5 with PP. SOM's were failed in 3 cases (2 PP and 1 EP). In 10 with EP. and intact gallbladder (GB) with 5 dilated and 5 normal CBD, 3 had abnormal SOM. Two with BP>40 mmHg and dilated CBD with intact GB underwent endoscopic sphincterotomy (ES) with complete relief in 1 during 4 years of follow-up and partial improvement in another. In 3 with PP, one had abnormal SOM and 2 with pancreatitis had normal SOM. Mild pancreatitis developed in 1 after SOM and ERCP and cholangitis in another with ES done.

Conclusions: The abnormal SOM in 4 out of 15 implies that SOD is not rare in our patients. Abnormal SOM in 1 of 6 with type III SOD and in 3 of 8 with type II SOD are comparable to other reports. The role of ES in patient with SOD and intact GB is unclear and our data are too limited to draw any conclusion. Our failure rate of SOM is similar to other centers. The pancreatitis may be due to SOM or therapeutic procedure after the SOM.

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