Previous cholecystectomy and choledochal sphincter spasm after morphine sedation.
OBJECTIVE
To describe a patient with probable choledochal sphincter spasm after preoperative morphine, and to suggest a history of cholecystectomy as a predisposing factor.


METHODS
A 60 yr old man for femoral-popliteal artery bypass grafting developed right upper quadrant abdominal pain after preoperative morphine and scopolamine. He had a previous cholecystectomy. His pain was relieved with naloxone.


CONCLUSIONS
Choledochal sphincter spasm should be part of a differential diagnosis in right upper quadrant pain after sedative doses of morphine, especially if there is a previous cholecystectomy.
Ho
A M
AM
Department of Anaesthesia and Intensive Care, Prince of Wales Hospital and Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, PRC. hoamh@hotmail.com
D002763:Cholecystectomy / Q000009:adverse effects*; D003137:Common Bile Duct Diseases / Q000209:etiology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects*; D013035:Spasm / Q000209:etiology*
D006993:Hypnotics and Sedatives; D009020:Morphine