1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul Korea 2Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul Korea
Corresponding author:
Byeong Moo Yoo,
ABSTRACT
Background/Aims: The gold standard for a definite diagnosis of sphincter of Oddi(SO) dyskinesia is abnormal findings on SO manometry done during ERCP examination. However, ERCP manometry is a cumbersome test and in some cases it is not technically successful. We evaluate ERCP findings in patients with SO dyskinesia(n=13) to clarify and characterize the cholangiographic findings, subsequently in order to help the diagnosis and eliminate cumbersome manometric test. Methods: All patients were confirmed as SO dyskinesia by ERCP manometry. They were 11 female and 2 male and age range was 32 to 75-year-old (mean; 52 year-old). All patients fulfilled Hogan & Geenen’s criteria for probable group II dysfunction of SO. Results: Dilated common bile duct(>12 mm) was noted in 11(85%) out of 13 patients. Inrrahepatic duct were proportionally dilaled as extrahepatic duct in 6 patients. In these cases, intrahepatic ducts branched normally and ductal wall was smooth. Eight(62%) out of 13 patients showed delayed emptying of contrast media(> 45 min) from the common bile duct into the duodenum. Transient or persistent pscudocalculus sign was observed in 10(77%) out of 13 patients. Following I.V. injection of cholecystokinin-octapeptide, persistent meniscus disappeared and contrast media inflowed into the duodenum. Conclusion: Identification of above-mentioned characteristic cholangiographic findings may eliminate the cumbersome manometric test for the diagnosis of SO dyskinesia.
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