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The duodenal bulb (also ampulla of duodenum, duodenal ampulla, or duodenal cap) is the initial, dilated portion of (the superior part of) the duodenum [1] just distal to the stomach; it begins at the pylorus and ends at the neck of the gallbladder. It is normally about 5 centimeters long.
The common duct then opens medially into the descending part of the duodenum at the major duodenal papilla. The common duct usually measures 2-10mm in length. [1] The ampulla of Vater is an important landmark halfway along the second part of the duodenum marking the transition from foregut to midgut. [citation needed]
The duodenal bulb is a remnant of the mesoduodenum, a mesentery that suspends the organ from the posterior abdominal wall in fetal life. [10] The first part of the duodenum is mobile, and connected to the liver by the hepatoduodenal ligament of the lesser omentum. The first part of the duodenum ends at the corner, the superior duodenal flexure.
The major duodenal papilla is situated in the second part of the duodenum, 7–10 cm from the pylorus, at the level of the second or third lumbar vertebrae. It is surrounded by the sphincter of Oddi , a circular muscle, and receives a mixture of pancreatic enzymes and bile from the Ampulla of Vater , which drains both the pancreatic duct and ...
The sphincter regulates the secretion of pancreatic juice and bile into the duodenum. [3] It also prevents reflux of duodenal contents into the ampulla of Vater. [4] By preventing reflux of the contents of the duodenum, the sphincter of Oddi prevents the accumulation of particulate matter and sludge in the bile ducts, reducing the risk of cholangitis.
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Insertion of a stent through the major duodenal papilla and ampulla of Vater into the common bile duct and/or the pancreatic duct; Dilation of strictures (e.g. primary sclerosing cholangitis, anastomotic strictures after liver transplantation) [5] Extraction of liver flukes from the biliary system (e.g., opisthorchiasis, clonorchiasis, fasciolosis)
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