Intrasphincteric injection of botulinum toxin for suspected XXXX .

@entity1 @entity1318 @entity1690 @entity158 @entity934
Botulinum toxin is a potent inhibitor of the release of @entity934 from nerve endings. It has previously been shown that it can effectively reduce lower oesophageal sphincter pressures both in animals and @entity1 with @entity1318 . This study examined the hypothesis that locally injected botulinum toxin could also reduce sphincter of Oddi pressure in @entity1 with @entity1690 . Two @entity1 with @entity158 were diagnosed with @entity1690 (by biliary manometry in one @entity1 and by hepatobiliary scanning criteria in the other). Botulinum toxin was injected into the sphincter of Oddi, by a sclerotherapy needle passed through a duodenoscope. In the first @entity1 , intrasphincteric injection of botulinum toxin reduced sphincter pressure by about 50%, an effect that was sustained for at least four months. In the second @entity1 , intrasphincteric injection caused about a 50% improvement in bile flow, with normalisation of scintigraphy. Neither @entity1 showed any sustained improvement in @entity158 despite these objective findings. Both @entity1 eventually had endoscopic sphincterotomy, which also did not result in symptomatic improvement in either @entity1 . No side effects were seen. Intrasphincteric botulinum toxin is a simple and effective means of lowering sphincter of Oddi pressure. This technique has potential for being useful clinically.
