Gong et al reported a classification for sphincter of Oddi dysfunction. The type of dysfunction can help to determne the optimum therapy. The authors are from the People's Liberation Army General Hospital of Chengdu Command in Sicuan Province, China.
Parameters)
(1) type of pain
(2) radiating pain
(3) onset of pain
(4) jaundice
(5) serum concentration of liver enzymes
(6) serum concentration of amylase
(7) bile duct diameter in mm on imaging studies
(8) pancreatic duct distension on imaging studies
(9) antegrade cholangiography voiding time
(10) unexpected findings on antegrade cholangiography
|
Parameter |
Bile Duct Type (Type I) |
Pancreatic Duct Type (Type II) |
|
pain |
retrosternal |
epigastric |
|
radiating pain |
central back |
left back or indeterminate |
|
onset of pain |
after high-fat meals |
after ordinary meals |
|
jaundice |
variable |
absent |
|
serum liver enzymes |
variable |
normal |
|
serum amylase |
normal |
elevated |
|
bile duct diameter |
>= 10 mm |
< 10 mm |
|
pancreatic duct distention |
absent |
marked |
|
voiding time on antegrade cholangiography |
> 10 minutes |
normal |
|
unexpected findings on antegrade cholangiography |
NA |
NA |
|
Parameter |
Bile and Pancreatic Duct Type (Type III) |
Biliary-Pancreatic Reflux Type (Type IV) |
|
pain |
retrosternal and epigastric |
epigastric |
|
radiating pain |
central back, left back or indeterminate |
left back or indeterminate |
|
onset of pain |
after ordinary or high-fat meals |
in the morning, at night |
|
jaundice |
variable |
absent |
|
serum liver enzymes |
elevated |
variable |
|
serum amylase |
variable |
elevated |
|
bile duct diameter |
>= 10 mm |
>= 10 mm |
|
pancreatic duct distention |
present |
present |
|
voiding time on antegrade cholangiography |
> 10 minutes |
NA |
|
unexpected findings on antegrade cholangiography |
NA |
pancreatic duct visualization |
Specialty: Gastroenterology
ICD-10: ,
