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Sphincter of Oddi dysfunction refers to a group of functional disorders leading to abdominal pain due to dysfunction of the Sphincter of Oddi: functional biliary sphincter of Oddi and functional pancreatic sphincter of Oddi disorder. The sphincter of Oddi is a sphincter muscle, a circular band of muscle at the bottom of the biliary tree which controls the flow of pancreatic juices and bile into the second part of the duodenum. The pathogenesis of this condition is recognized to encompass stenosis or dyskinesia of the sphincter of Oddi (especially after cholecystectomy); consequently the terms biliary dyskinesia, papillary stenosis, and postcholecystectomy syndrome have all been used to describe this condition. Both stenosis and dyskinesia can obstruct flow through the sphincter of Oddi and can therefore cause retention of bile in the biliary tree and pancreatic juice in the pancreatic duct. Individuals with sphincter of Oddi dysfunction present with abdominal pain resembling that of structural or inflammatory disorders of the gallbladder, biliary tree or pancreas. Among other characteristics, the pain is typically in the upper part of the abdomen or in the right upper quadrant of the abdomen, lasts 30 minutes or longer, and is not associated with a structural abnormality that could lead to these symptoms. The disorder is classified into two subtypes: functional biliary sphincter of Oddi disorder, where there is no disturbance in pancreatic enzyme measurements, such as amylase and lipase; and, functional pancreatic sphincter of Oddi disorder, where pancreatic enzyme measurements are elevated. Attacks can be precipitated by opioid analgesics,〔http://www.anzca.edu.au/fpm/events/fpm-events/1-CBell.pdf〕 particularly in patients having undergone cholecystectomy (gall bladder removal) or who have had bariatric surgery (Gastric Bypass or weight loss surgery). ==Classification== Functional disorders of the gallbladder, bile duct and pancreas have been defined and classified by the Rome criteria for functional gastrointestinal disorders. The criteria outline three variants of functional disorders of the gallbladder, bile duct and pancreas, termed ''functional gallbladder disorder'', ''functional biliary sphincter of Oddi disorder'' and ''functional pancreatic sphincter of Oddi disorder''. All of the following criteria need to be met for as part of the definition of a functional disorder of the gallbladder:〔 *the pain must be located in the upper part of the abdomen and/or the right upper quadrant of the abdomen *episodes of pain must last at least 30 minutes *the symptoms must be recurrent, and occur at differing intervals *the pain must incrementally increase to a "steady level" *the pain must be severe enough the patient's daily activities are affected, or that the patient must attend the emergency department *the pain must not be relieved by any of bowel movements, change in posture, or antacids; and, *other structural disorders that could explain the symptoms must be excluded. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Sphincter of Oddi dysfunction」の詳細全文を読む スポンサード リンク
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