The morphine prostigmine provocation (Nardi) test for sphincter of Oddi dysfunction: results in healthy volunteers and in patients before and after transduodenal sphincteroplasty and transampullary septectomy

Lobo, Dileep N.; Takhar, Arjun; Thaper, Arushi; Dube, Mukesh

doi:10.1136/gut.2007.126375

Cited by 19 publications

(21 citation statements)

References 5 publications

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“…A positive test is defined by a fourfold rise in serum amylase or lipase along with reproduction of abdominal pain after intramuscular introduction of 10 mg of morphine and 1 mg of prostigmine. Although initial results were promising, subsequent evaluation revealed a lack of specificity precluding widespread use [51]. …”

Section: Diagnostic Modalitiesmentioning

confidence: 99%

Gallbladder Dysfunction: How Much Longer Will It Be Controversial?

Goussous¹,

Kowdley²,

Sardana³

et al. 2014

Digestion

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Background: Motility disorders of the biliary tree [biliary dyskinesia, including both gallbladder dysfunction (GBD), and sphincter of Oddi dysfunction] are difficult to diagnose and to treat. Summary: There is controversy in the literature in particular regarding the criteria that should be used to select patients for cholecystectomy (CCY) in cases of suspected GBD. The current review covers the history, diagnosis, and treatment of GBD. Key Messages: Only >85% of patients with suspected GBD have relief following CCY, a much lower rate than the nearly 100% success rate following CCY for gallstone disease. Unfortunately, the literature is lacking, and there are no universally agreed-upon criteria for selecting which patients to refer for operation, although cholecystokinin (CCK)-enhanced hepatobiliary iminodiacetic acid scan is often used, with emphasis on an abnormally low gallbladder ejection fraction or pain reproduction at CCK administration. There is a clear need for large, well-designed, more definitive, prospective studies to better identify the indications for and efficacy of CCY in cases of GBD. i 2014 S. Karger AG, Basel

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Section: Diagnostic Modalitiesmentioning

confidence: 99%

Gallbladder Dysfunction: How Much Longer Will It Be Controversial?

Goussous¹,

Kowdley²,

Sardana³

et al. 2014

Digestion

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“…A more than four times increase in the serum concentration of AST, ALT and/or amylase associated with generation of abdominal pain are regarded as positive. Although this test is simple and practical, it has been claimed that the specificity and reproducibility of this test are rather low, because it may produce SO spasm associated with nonspecific abdominal pain due to bowel spasm [10]. …”

Section: So Function Testsmentioning

confidence: 99%

Function and Dysfunction of the Sphincter of Oddi

Tanaka¹

2010

Dig Surg

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In this review, the function of the sphincter of Oddi (SO) is detailed in terms of normal motility, neural and hormonal control of SO function, coordination between gallbladder and SO motility, and correlation of motility of the SO and the duodenum. In addition, SO function tests, such as the morphine Prostigmin test (Nardi test), perfusion manometry, microtransducer manometry, and cholescintigraphy, are explained. Subsequently, the pathophysiology, diagnosis, and treatment of SO dysfunction, including SO stenosis and dyskinesia, are described and discussed in detail. SO manometry and endoscopic sphincterotomy are effective to treat SO dysfunction, but symptoms of the patient must be severe enough to justify these invasive procedures for diagnosis and treatment.

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“…Five studies were included that investigated this test (Table 3) [6][7][8][9][10]. Three articles found that the test lacked sufficient specificity to be useful [6,7,9].…”

Section: Diagnostic Methodsmentioning

confidence: 99%

The diagnosis and management of Sphincter of Oddi dysfunction: a systematic review

Hall

Dennison

Garcea

2012

Langenbecks Arch Surg

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Non-invasive investigations currently lack sufficient sensitivities and specificities for routine use in diagnosing SOD. Type I SOD should be treated with ES without manometry. Manometry may be useful for Type II SOD. However, whilst data is lacking a therapeutic trial of Botox(TM) or trial stenting may bean alternative. Careful and thorough patient counselling is essential. Type III SOD is associated with high complications from manometry and poor outcomes from ES. Alternative diagnoses should be thoroughly sought and its management should be medical.

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The morphine prostigmine provocation (Nardi) test for sphincter of Oddi dysfunction: results in healthy volunteers and in patients before and after transduodenal sphincteroplasty and transampullary septectomy

Cited by 19 publications

References 5 publications

Gallbladder Dysfunction: How Much Longer Will It Be Controversial?

Gallbladder Dysfunction: How Much Longer Will It Be Controversial?

Function and Dysfunction of the Sphincter of Oddi

The diagnosis and management of Sphincter of Oddi dysfunction: a systematic review

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