Ampulla of Vater/duodenal wall spasm diagnosed by antroduodenal manometry.

Abstract:

:Patients with chronic epigastric to right upper quadrant pain are often considered to have gallbladder of sphincter of Oddi dysfunction, but standard tests are nondiagnostic. In 62 consecutive patients with this compliant undergoing antroduodenal manometry, we correlated a change on duodenal motility with spasm of the ampulla of Vater/duodenal wall. This distinctive motility pattern occurred and was analyzed in 35% of patients. It is characterized by increased duodenal wall tone with phasic contractions of 19-22 or 41-44 contractions/min or by phasic activity alone. The subjects with spasm also underwent cholecystokinin cholescintigraphy, and 50% showed either significantly delayed gallbladder emptying of hilum to small intestine emptying, or both. The disorder appears to be secondary to a loss of neural inhibitory control and a dysfunctional small-bowel pacemaker. Antroduodenal manometry is an essential diagnostic procedure that complements sphincter of Oddi manometry in evaluation of unexplained right upper quadrant pain.

journal_name

Dig Dis Sci

authors

Koussayer T,Ducker TE,Clench MH,Mathias JR

doi

10.1007/BF02212692

subject

Has Abstract

pub_date

1995-08-01 00:00:00

pages

1710-9

issue

8

eissn

0163-2116

issn

1573-2568

journal_volume

40

pub_type

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