Curbside Consultation of the Pancreas: 49 Clinical Questions

Scott Tenner, MD, MPH; Alphonso Brown, MD, MS Clin Epi; Frank Gress, MD

Question 47: What Is The Best Approach To The Patient With Suspected Sphincter Of Oddi Dysfunction? (continued)

Nison Badalov, MD; Scott Tenner, MD, MPH

The single most important aspect of treating a patient suspected of having sphincter of Oddi dysfunction (SOD) is to be certain of the diagnosis. There are 3 types of SOD (Table 47-1). Although the sphincter may be found to be hypertensive in these patients on manometry, differences in the clinical presentation exist and correlate with the likelihood of the diagnosis. While a patient with recurrent attacks of pancreatitis or biliary-like pain who also presents with a dilated common bile duct (CBD) and abnormal liver function tests, in the absence of obvious tumor, cholelithiasis, and…