Postcholecystectomy syndrome mimicking angina pectoris detected by the morphine provocation test.
A 66-year old woman had had intermittent anterior chest pain and upper abdominal pain for 15 years. Angina pectoris was diagnosed at the age of 51 years, as she had typical anginal pain that was relieved by nitroglycerine, although coronary arteriography was normal and the ergonovine provocative test was negative. She had undergone cholecystectomy at the age of 38 years. Her bile duct pressure increased markedly after morphine injection and severe pain with the aforementioned distribution was produced. Postcholecystectomy syndrome due to sphincter of Oddi spasm was diagnosed and her pain was relieved by endoscopic sphincterotomy.
Osawa
H
H
Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School.
Saito
M
M
Fujii
M
M
Yamanaka
T
T
Yaginuma
T
T
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000628:therapy; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D009020:Morphine; D017562:Postcholecystectomy Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D009803:Sphincter of Oddi / Q000503:physiopathology; D016717:Sphincterotomy, Endoscopic
D009020:Morphine