cqvip:Objective. Although acute pancreatitis is the most significant complication o f sphincter of Oddi manometry (SOM), acute biliary- like abdominal pain - sim ilar or identical to the patient’ s usual recurrent acute episodes of pain and not fulfilling clinical criteria for acute pancreatitis - can also be provoked by SOM. The aim of the article is to determine and compare the relative frequen cy of occurrence of, and risk factors for, postmanometry biliary- like abdomina l pain and post- manometry pancreatitis. Material and methods. The clinical and laboratory features, the manometric recordings from the sphincter of Oddi, and the immediate post- manometry outcomes, were examined in 234 consecutive patien ts undergoing sphincter of Oddi manometry at our Unit. Results. Post- manometry pancreatitis occurred in 9% of patients, and was associated with two risk fac tors on multivariate analysis: a history of post- ERCP pancreatitis (odds ratio [OR] 5.9) and a raised basal sphincter pressure (≥ 40 mmHg) at SOM (OR 3.5). A n increased sphincter phasic wave frequency (≥ 7/ min) at SOM was identified as a significant (p < 0.05) risk factor on univariate testing only. Post- manomet ry biliary- like pain occurred in 12% of patients, and was associated with 3 different risk factors on multivariate analysis: age below 50 years (OR 4.6); le ss than a 2- year history of recurrent abdominal pain (OR 3.0); and ERCP and/or ES carried out during the SOM procedure (OR 9.3). Conclusions. Provocation of b iliary- like pain following SOM, without clinical evidence of pancreatitis, occ urs at least as frequently as post- manometry acute pancreatitis. In contrast t o post- manometry pancreatitis, post- manometry biliary- like pain occurs mor e often in younger patients with a shorter duration of symptoms and does not app ear related to the manometric features of the sphincter documented at SOM; we pr opose that this clinical entity may reflect the presence of bile duct or duodena l hypersensitivity/ hyperalgesia.
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