Sphincter of Oddi dysfunction is associated with chronic pancreatitis.
OBJECTIVE
Chronic pancreatitis can be caused by ductal obstruction resulting from cicatricial papillary stenosis, but sphincter of Oddi motility studies have been inconclusive in patients with established chronic pancreatitis. We sought to determine whether there is an association between papillary sphincter dysfunction and changes of early chronic pancreatitis.


METHODS
Consecutive patients who underwent sphincter of Oddi manometry to investigate unexplained upper abdominal pain (n = 104) were assessed for evidence of chronic pancreatitis by pancreatic ductography, endoscopic ultrasound, and pancreatic fluid bicarbonate concentration.


RESULTS
Sphincter of Oddi dysfunction patients were four times more likely (odds ratio = 4.6) to have evidence of chronic pancreatitis than were those without sphincter dysfunction (p = 0.01). Of 68 patients with sphincter of Oddi dysfunction, 20 (29%) had structural evidence of chronic pancreatitis. Twenty of 23 (87%) patients with chronic pancreatitis had sphincter of Oddi dysfunction.


CONCLUSIONS
Sphincter of Oddi dysfunction is associated with changes of chronic pancreatitis in patients with unexplained pancreaticobiliary pain. Longitudinal follow-up is required to confirm these preliminary findings.
Tarnasky
P R
PR
Medical University of South Carolina, Digestive Disease Center, Charleston, USA.
Hoffman
B
B
Aabakken
L
L
Knapple
W L
WL
Coyle
W
W
Pineau
B
B
Cunningham
J T
JT
Cotton
P B
PB
Hawes
R H
RH
D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000503:physiopathology; D004378:Duodenal Diseases / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index; D009803:Sphincter of Oddi / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography / Q000379:methods