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Sphincter dysfunction

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction The sphincters in the human body are found in the digestive tract and the urinary system. When the sphincter contracts, the lumen can be closed. When the sphincter is closed, the lumen is opened, and it is often in a contracted state. Generally subject to plant innervation or hormone regulation. Oddi sphincter (SO) dysfunction refers to abnormal motility of the pancreatic duct and pancreatic duct; its main symptom is right upper quadrant or upper abdominal pain, which is often confused with other functional gastrointestinal diseases. Symptoms of gallbladder and biliary SO dysfunction are similar; pancreatic duct SO dysfunction is similar to acute pancreatitis.

Cause

Cause

Often induced by eating, especially into fatty foods, may be associated with abnormal liver function, elevated serum amylase, choledochal dilatation or ERCP after the choledochal or pancreatic duct contrast agent emptying delay. Primary oddi sphincter motor dysfunction, often without bile duct stones and other clear causes, oddi sphincter stenosis or motor dysfunction is its main cause.

Examine

an examination

Related inspection

Serum amylase (AMS) liver function test

Diagnostic criteria

The patient must have a paroxysmal upper abdominal or upper right abdominal pain, and all of the following conditions should be met: 1. The duration of abdominal pain lasts for at least 30 minutes; 2. The intermittent intermittent recurrence of symptoms and the interval between episodes (non-daily episodes); 3. Pain Aggravation to a relatively stable level; 4. Moderate or severe pain affects patients' daily life or causes patients to seek emergency medical treatment; 5. Abdominal pain does not relieve after defecation; 6. Postural changes do not relieve abdominal pain; 7. Antacids can not relieve abdominal pain; 8. Exclude others An organic disease that can cause abdominal pain.

One or more of the following features support the diagnosis of gallbladder and SO dysfunction: 1. abdominal pain accompanied by nausea and vomiting; 2. pain radiated to the back and/or right subscapular area; 3. midnight wakefulness.

Diagnosis

Differential diagnosis

Gallbladder and Oddi sphincter (SO) dysfunction are rare, the main symptoms are right upper quadrant or upper abdominal pain, often difficult to interact with other functional gastrointestinal diseases such as gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS) and functional dyspepsia (FD) identification, it is also difficult to identify cholecystitis and pancreatitis caused by cholelithiasis.

Gallbladder dysfunction: refers to biliary abdominal pain caused by metabolic or primary gallbladder dysmotility, and no bile component changes, the diagnosis must meet all of the following conditions: 1. Meet the diagnostic criteria of gallbladder and SO dysfunction; 2. Gallbladder Existence; 3. Liver enzyme, conjugated bilirubin, blood amylase or lipase is normal.

SO dysfunction: refers to abdominal pain caused by abnormal SO movement, elevated liver enzyme or pancreatic enzyme, biliary dilatation or pancreatitis. According to the location of abnormal SO dynamics, it can be divided into biliary type and pancreatic type. Although patients with gallbladder may also have SO dysfunction, this condition is common in patients after cholecystectomy.