# Rome IV pancreatic sphincter of Oddi disorder

Rome IV pancreatic SOD

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/rome_iv_pancreatic_sod`
HTML: https://magentlab.com/docs/rome-iv-pancreatic-sod
Markdown: https://magentlab.com/docs/rome-iv-pancreatic-sod.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Apply the Cotton 2016 Rome IV E2 pancreatic sphincter of Oddi disorder diagnostic criteria and return whether the published pancreatic SOD box holds (rome_iv_pancreatic_sod).

## When to use

When an agent already has the four caller-assigned Cotton 2016 Rome IV E2 pancreatic SOD flags and needs whether the published E2 box holds. magent does not read endoscopic ultrasound, sphincter manometry, labs, or imaging.

## When not to use

- Not a medical device.
- Not a diagnosis. magent does not diagnose pancreatic sphincter of Oddi disorder.
- The caller assigns the four flags. magent does not read endoscopic ultrasound, sphincter manometry, labs, or imaging.
- This tool is Cotton 2016 Rome IV E2 pancreatic sphincter of Oddi disorder only. Not biliary SOD. Not functional gallbladder. Not a treatment recommendation for sphincterotomy.

## Formula

```
rome_iv_pancreatic_sod iff documented_recurrent_episodes_of_pancreatitis and other_etiologies_of_pancreatitis_excluded and negative_endoscopic_ultrasound and abnormal_sphincter_manometry (Cotton 2016 Rome IV E2 pancreatic sphincter of Oddi disorder)
```

## Citation

[Gallbladder and Sphincter of Oddi Disorders](https://doi.org/10.1053/j.gastro.2016.02.033)
Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES
Gastroenterology. 2016;150(6):1420-1429
DOI: [10.1053/j.gastro.2016.02.033](https://doi.org/10.1053/j.gastro.2016.02.033)

## Worked example

### All four required flags

Given: `abnormal_sphincter_manometry=true, documented_recurrent_episodes_of_pancreatitis=true, negative_endoscopic_ultrasound=true, other_etiologies_of_pancreatitis_excluded=true`

1. Documented recurrent episodes of pancreatitis is true
2. Other etiologies of pancreatitis excluded is true
3. Negative endoscopic ultrasound is true
4. Abnormal sphincter manometry is true
5. rome_iv_pancreatic_sod is true


### Three required flags without abnormal manometry

Given: `abnormal_sphincter_manometry=false, documented_recurrent_episodes_of_pancreatitis=true, negative_endoscopic_ultrasound=true, other_etiologies_of_pancreatitis_excluded=true`

1. Three required flags hold
2. Abnormal sphincter manometry is false
3. rome_iv_pancreatic_sod is false


## Also searched as

- Rome IV pancreatic SOD
- Rome IV pancreatic sphincter of Oddi
- Cotton 2016 E2
- pancreatic sphincter of Oddi disorder
- Rome IV E2 SOD
- sphincter of Oddi pancreatitis
- Cotton 2016 pancreatic SOD
- Rome IV SOD pancreatic

## Parameters

- `documented_recurrent_episodes_of_pancreatitis` (boolean, required): Documented recurrent episodes of pancreatitis (typical pain with amylase or lipase >3 times normal and/or imaging evidence of acute pancreatitis), as assigned (Cotton 2016 Rome IV E2). One caller flag; magent does not split amylase versus imaging. true or false as assigned by the caller. magent does not read labs or imaging.
- `other_etiologies_of_pancreatitis_excluded` (boolean, required): Other etiologies of pancreatitis excluded, as assigned (Cotton 2016 Rome IV E2). true or false as assigned by the caller. magent does not read labs or imaging.
- `negative_endoscopic_ultrasound` (boolean, required): Negative endoscopic ultrasound, as assigned (Cotton 2016 Rome IV E2). true or false as assigned by the caller. magent does not read endoscopic ultrasound.
- `abnormal_sphincter_manometry` (boolean, required): Abnormal sphincter manometry, as assigned (Cotton 2016 Rome IV E2). true or false as assigned by the caller. magent does not read sphincter manometry.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/rome_iv_pancreatic_sod`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "abnormal_sphincter_manometry": "true",
      "documented_recurrent_episodes_of_pancreatitis": "true",
      "negative_endoscopic_ultrasound": "true",
      "other_etiologies_of_pancreatitis_excluded": "true"
    },
    {
      "abnormal_sphincter_manometry": "true",
      "documented_recurrent_episodes_of_pancreatitis": "true",
      "negative_endoscopic_ultrasound": "true",
      "other_etiologies_of_pancreatitis_excluded": "true"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/rome-iv-pancreatic-sod

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/rome_iv_pancreatic_sod",
  "items": [
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES",
        "doi": "10.1053/j.gastro.2016.02.033",
        "id": "cotton-2016",
        "pmid": "27144629",
        "source": "Gastroenterology. 2016;150(6):1420-1429",
        "title": "Gallbladder and Sphincter of Oddi Disorders"
      },
      "formula": "rome_iv_pancreatic_sod",
      "formula_expression": "rome_iv_pancreatic_sod iff documented_recurrent_episodes_of_pancreatitis and other_etiologies_of_pancreatitis_excluded and negative_endoscopic_ultrasound and abnormal_sphincter_manometry (Cotton 2016 Rome IV E2 pancreatic sphincter of Oddi disorder)",
      "criteria": [
        {
          "factor": "documented_recurrent_episodes_of_pancreatitis",
          "met": true
        },
        {
          "factor": "other_etiologies_of_pancreatitis_excluded",
          "met": true
        },
        {
          "factor": "negative_endoscopic_ultrasound",
          "met": true
        },
        {
          "factor": "abnormal_sphincter_manometry",
          "met": true
        }
      ],
      "rome_iv_pancreatic_sod": true
    },
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES",
        "doi": "10.1053/j.gastro.2016.02.033",
        "id": "cotton-2016",
        "pmid": "27144629",
        "source": "Gastroenterology. 2016;150(6):1420-1429",
        "title": "Gallbladder and Sphincter of Oddi Disorders"
      },
      "formula": "rome_iv_pancreatic_sod",
      "formula_expression": "rome_iv_pancreatic_sod iff documented_recurrent_episodes_of_pancreatitis and other_etiologies_of_pancreatitis_excluded and negative_endoscopic_ultrasound and abnormal_sphincter_manometry (Cotton 2016 Rome IV E2 pancreatic sphincter of Oddi disorder)",
      "criteria": [
        {
          "factor": "documented_recurrent_episodes_of_pancreatitis",
          "met": true
        },
        {
          "factor": "other_etiologies_of_pancreatitis_excluded",
          "met": true
        },
        {
          "factor": "negative_endoscopic_ultrasound",
          "met": true
        },
        {
          "factor": "abnormal_sphincter_manometry",
          "met": true
        }
      ],
      "rome_iv_pancreatic_sod": true
    }
  ]
}
```

## Response fields

- `formula` (string): rome_iv_pancreatic_sod
- `formula_expression` (string): Cotton 2016 Rome IV E2 pancreatic sphincter of Oddi disorder: documented recurrent episodes of pancreatitis, other etiologies of pancreatitis excluded, negative endoscopic ultrasound, and abnormal sphincter manometry
- `rome_iv_pancreatic_sod` (boolean): true only when all four required flags hold. Not a diagnosis.
- `criteria` (array): Per-factor rows with factor and met for the four required flags
- `citation` (object): Cotton 2016 Gastroenterology citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES",
    "doi": "10.1053/j.gastro.2016.02.033",
    "id": "cotton-2016",
    "pmid": "27144629",
    "source": "Gastroenterology. 2016;150(6):1420-1429",
    "title": "Gallbladder and Sphincter of Oddi Disorders"
  },
  "formula": "rome_iv_pancreatic_sod",
  "formula_expression": "rome_iv_pancreatic_sod iff documented_recurrent_episodes_of_pancreatitis and other_etiologies_of_pancreatitis_excluded and negative_endoscopic_ultrasound and abnormal_sphincter_manometry (Cotton 2016 Rome IV E2 pancreatic sphincter of Oddi disorder)",
  "criteria": [
    {
      "factor": "documented_recurrent_episodes_of_pancreatitis",
      "met": true
    },
    {
      "factor": "other_etiologies_of_pancreatitis_excluded",
      "met": true
    },
    {
      "factor": "negative_endoscopic_ultrasound",
      "met": true
    },
    {
      "factor": "abnormal_sphincter_manometry",
      "met": true
    }
  ],
  "rome_iv_pancreatic_sod": true
}
```

## Errors

- HTTP 400 `invalid_rome_iv_pancreatic_sod`: Rome IV pancreatic SOD needs the Cotton 2016 E2 recurrent-pancreatitis and investigation flags. Returned before settlement; you are not charged.
- HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [Rome IV biliary SOD](https://magentlab.com/docs/rome-iv-biliary-sod) — Apply the Cotton 2016 Rome IV E1b functional biliary sphincter of Oddi disorder diagnostic criteria and return whether the published E1b box holds (rome_iv_biliary_sod). Elevated liver enzymes XOR dilated bile duct is required. Supportive flags are reported and not required.
- [Rome IV biliary pain](https://magentlab.com/docs/rome-iv-biliary-pain) — Apply the Cotton 2016 Rome IV E1 diagnostic criteria for biliary pain and return whether the published biliary-pain box holds (rome_iv_biliary_pain) plus three supportive flags.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.