Diazepam does not modify the motility of the sphincter of Oddi.
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Biomedical subjects
Publications and source records attributed to V Pertejo.
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An endoscopic biliary manometry was performed on 11 patients with a surgical bilioenteric shunt--choledochoduodenostomy--and no pressure gradient between common bile duct and duodenum. Basal pressure and frequency of the phasic waves of the sphincter of Oddi were significantly higher in these patients than in controls or in patients with retained common bile duct stones. These results suggest a functional adaptation of the sphincter of Oddi in an attempt to recover the normal pressure in the biliary tract.
We studied the Oddi sphincter motility by endoscopic manometry in 10 consecutive patients randomized in a double-blind fashion, after i.v. administration of two anticholinergic compounds (0.5 mg atropine sulfate and 10 mg pirenzepine). Pirenzepine significantly decreased the basal sphincteric pressure, as well as the amplitude and frequency of the phasic contractions. The only significant effect of atropine was the modification of the frequency of the phasic contractions, but only for a short period of time. Our results suggest that muscarinic innervation must be present for a normal sphincter of Oddi motility.
Pressures in the sphincter of Oddi and common bile duct were determined in eight patients with previous surgical sphincterotomy, and in 14 patients before and after endoscopic sphincterotomy. Motor activity in the sphincter of Oddi was seen during manometric examination in 6 out of 8 patients of the surgical group. These six patients had common bile duct stones after cholecystectomy. Endoscopic sphincterotomy equalized the choledochoduodenal gradient and reduced the sphincter pressure in all the patients except three. In two of them further extension of the length of the sphincterotomy permitted removal of the stones and substantial reduction of the motor activity of the sphincter of Oddi.
A 42-year-ole woman developed ischemic colitis shortly after the administration of a cleansing enema. As possible predisposing factor in out patient we assess treatment with contraceptives by parenteral route, started one year before her episode of bowel ischemia. To out knowledge, this is the first patient without underlying pathology with proven ischemic colitis secondary to a cleansing enema.
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