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 (also hepatopancreatic sphincter or Glisson's sphincter), abbreviated as SO, is a muscular valve that in some animals, including humans, controls the flow of digestive juices (bile and pancreatic juice) out of the pancreas t ...

, a valve which divides the

biliary tract The biliary tract, (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 and co ...

from the

duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...

. Two medications,

morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a analgesic, pain medication, and is also commonly used recreational drug, recreationally, or to make ...

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 the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...

s concerning for sphincter dysfunction, including sharp right-sided

abdominal pain Abdominal pain, also known as a stomach ache, is a symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than ...

. 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