Abstract
SOD refers to a benign functional disorder that affects the sphincter of Oddi. Type III SOD defined by revised Milwaukee classification refers to biliary type pain w/o elevated LFTs or dilated CBD. Type III SOD remains one of the more obscure entities in terms of pathogenesis & treatment response. SOD more commonly occurs in females, is reported to negatively impact quality of life with increased disability, time lost from work & overuse of healthcare. Patients usually present with abdominal pain (epigastric/RUQ). SOM remains the gold standard study. SOM results in increased risk of post ERCP acute pancreatitis (AP) (approaching 20%) & performed only at tertiary centers. 25%-60% of SOD III pts have established increased pressures in either sphincter. Those pts with basal SOP of ≥ 40mmHg may experience benefit from endoscopic sphincterotomy (ES). Reports state a 55-65% response to ES in these pts.
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