A Case of Acute Cholangitis Due to Opioid-induced Dysfunction of Sphincter of Oddi in the Patient with Breast Cancer

Yasutomo Kumakura; Emi Nakajima; Kazuki Akita; Kimie Nakajima; Hiroki Ishiguro; Tetsuya Iijima

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A Case of Acute Cholangitis Due to Opioid-induced Dysfunction of Sphincter of Oddi in the Patient with Breast Cancer

VernacularTitle:原因不明の腹痛に対してオピオイド鎮痛薬を使用していた乳がん患者において，オピオイド誘発性オッジ括約筋機能不全に伴う急性胆管炎を発症した1症例
Author: Yasutomo KUMAKURA ¹ ; Emi NAKAJIMA ² ; Kazuki AKITA ¹ ; Kimie NAKAJIMA ² ; Hiroki ISHIGURO ² ; Tetsuya IIJIMA ³
Author Information

1. Center of Medical team, University of Yamanashi Hospital
2. Department of Anesthesiology, University of Yamanashi
3. Department of Nursing, University of Yamanashi Hospital
Keywords: sphincter of Oddi dysfunction; opioid peptides; cholangitis; cholestasis
From:Palliative Care Research 2020;15(1):29-33
CountryJapan
Language:Japanese
Abstract: Opioids are known to cause dysfunction of the sphincter of Oddi. However, there are no reports on acute cholangitis due to opioid-induced dysfunction of the sphincter of Oddi. A 75-year-old woman with breast cancer, who had been prescribed oxycodone for lower abdominal pain due to unknown causes for 8 years, suddenly developed hypochondriac pain. We diagnosed the patient as having acute cholangitis and performed endoscopic retrograde pancreatography and technetium hepatobiliary iminodiacetic acid scan. The cause of acute cholangitis was considered to be opioid-induced dysfunction of the sphincter of Oddi. Six and nine days after admission, endoscopic sphincterotomy was performed, after which her upper abdominal pain resolved. Opioids increase biliary pressure and delay bile flow into the duodenum in patients after cholecystectomy. However, the actual clinical outcomes of using opioids for acute cholangitis and pancreatitis remain unknown. Thus, although opioid-induced dysfunction of the sphincter of Oddi is uncommon, it should be assessed in patients who are prescribed opioids.