The Nardi test, also known as the morphine-neostigmine provocation test is a test for dysfunction of the

sphincter of Oddi The sphincter of Oddi (SO) (also hepatopancreatic sphincter or Glisson's sphincter), is a sphincter, a muscular valve that, in humans and some animals, controls the flow of bile and pancreatic juice out of the gallbladder and pancreas respective ...

, a valve which divides the

biliary tract The biliary tract (also biliary tree or biliary system) refers to the liver, gallbladder and bile ducts, and how they work together to make, store and secrete bile. Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids an ...

from the

duodenum The duodenum is the first section of the small intestine in most vertebrates, including mammals, reptiles, and birds. In mammals, it may be the principal site for iron absorption. The duodenum precedes the jejunum and ileum and is the shortest p ...

. Two medications,

morphine Morphine, formerly also called morphia, is an opiate that is found naturally in opium, a dark brown resin produced by drying the latex of opium poppies (''Papaver somniferum''). It is mainly used as an analgesic (pain medication). There are ...

and

neostigmine Neostigmine, sold under the brand name Bloxiverz, among others, is a medication used to treat myasthenia gravis, Ogilvie syndrome, and urinary retention without the presence of a blockage. It is also used in anaesthesia to end the effects of n ...

, are given to people with

symptom Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

s concerning for sphincter dysfunction, including sharp right-sided

abdominal pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given th ...

. If the pain is reproduced by the medications, then dysfunction is more likely. The test poorly predicts dysfunction, however, and is rarely used today. The Nardi test was named for George Nardi, who first described the procedure in 1966.

References

*Nardi GL, Acosta JM.''Papillitis as a cause of pancreatitis and abdominal pain: role of evocative test, operative pancreatography and histologic evaluation.'' Ann. Surg. 1966 Oct;164(4):611-21. *Steinberg WM. ''Sphincter of Oddi dysfunction: a clinical controversy.'' Gastroenterology 1988;95:1409-1415 {{Digestive system and abdomen symptoms and signs Medical tests