Clinical Presentation
Prostigmine-morphine provocation led to substantial increases in Tmax and T1/2 over various regions, reflecting a complete spasm at the sphincter of Oddi level, as visualized by quantitative hepatobiliary scintigraphy [PMID:9431903].
Differential Diagnosis
N-butylscopolamine (20 mg) notably decreased contraction frequency but did not significantly impact basal sphincter pressure, indicating its specific mechanism of action [PMID:8794800].
Management
Glyceryl trinitrate infusion (Nitrolingual 1 μg/kg/min for 120 min) normalized the increased time to peak activity (Tmax) and half-time of excretion (T1/2) over the liver parenchyma, hepatic hilum, and common bile duct, indicating its sphincter-relaxing effect [PMID:9431903].
Glyceryl trinitrate was administered at a dose of 1 μg/kg/min for a duration of 120 minutes, demonstrating significant relief from sphincter of Oddi spasm [PMID:9431903].
Intravenous administration of dipyrone (2.5 g) significantly reduced basal sphincter pressure of the Oddi sphincter compared to other analgesics like tramadol and indomethacin [PMID:8794800].
Nitroglycerin (1 mg) significantly lowered both basal sphincter pressure and contraction frequency, suggesting its potential role in managing sphincter of Oddi spasm [PMID:8794800].
References
1 Velosy B, Madácsy L, Lonovics J, Csernay L. Effect of glyceryl trinitrate on the sphincter of Oddi spasm evoked by prostigmine-morphine administration. European journal of gastroenterology & hepatology 1997. link 2 Brandstätter G, Schinzel S, Wurzer H. Influence of spasmolytic analgesics on motility of sphincter of Oddi. Digestive diseases and sciences 1996. link
2 papers cited of 3 indexed.