title: Relief by naloxone of morphine-induced spasm of the sphincter of Oddi in a post-cholecystectomy patient.
abstract: Spasm of the sphincter of Oddi is a well-recognized effect of the narcotic class of drugs. Although it is usually clinically silent, such spasm occasionally causes debilitating pain that may be mistaken for more serious disorders. We present the case of a patient who had undergone cholecystectomy previously, but in whom morphine given in the Emergency Department precipitated pain consistent with biliary colic; the pain resolved promptly after administration of naloxone. This entity may considered in the differential diagnosis of acute onset of colicky abdominal pain in the patient given narcotics.
authors.affiliation: Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona 85008, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Butler
authors.forename: B
authors.initials: B
authors.lastname: Selden
authors.forename: C V
authors.initials: CV
authors.lastname: Pollack
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D001660:Biliary Tract Diseases / Q000175:diagnosis; D002763:Cholecystectomy; D003085:Colic / Q000175:diagnosis; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D009020:Morphine / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010146:Pain / Q000139:chemically induced* / Q000188:drug therapy*; D011184:Postoperative Period; D013035:Spasm / Q000139:chemically induced*; D009803:Sphincter of Oddi / Q000187:drug effects*
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone; D009020:Morphine