Botulinum toxin injection as a diagnostic tool for verification of sphincter of Oddi dysfunction causing recurrent pancreatitis.
Sphincter of Oddi dyskinesia (SOD) is among the less frequent causes of acute recurrent pancreatitis. We report on a patient with frequent pain attacks accompanied by pancreatic enzyme elevation, in whom a transitory decrease of the SO pressure following endoscopic botulinus toxin injection was a diagnostic clue for SOD. The patient's symptoms resolved for 4 months, after which time recurrent symptoms paralleled the reoccurrence of the elevated SO pressure. Endoscopic sphincterotomy of the biliary sphincter relieved her symptoms for the subsequent follow-up period which is now 10 months.
Muehldorfer
S M
SM
Dept. of Medicine I, University of Erlangen-Nuremberg, Germany.
Hahn
E G
EG
Ell
C
C
D000208:Acute Disease; D000328:Adult; D000681:Amylases / Q000097:blood; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002779:Cholestasis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D003137:Common Bile Duct Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008049:Lipase / Q000097:blood; D010195:Pancreatitis / Q000209:etiology*; D011312:Pressure; D012008:Recurrence; D012074:Remission Induction; D009803:Sphincter of Oddi / Q000503:physiopathology* / Q000601:surgery; D016717:Sphincterotomy, Endoscopic
D018726:Anti-Dyskinesia Agents; D008049:Lipase; D000681:Amylases; D001905:Botulinum Toxins