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The junction between the foregut and midgut occurs directly below the major duodenal papilla. [3]: 274 The major duodenal papilla projects less than a centimetre into the lumen of the duodenum. [4] It appears rounded and is often covered by a fold on the uppermost side of the papilla; that is, the side which receives contents from the stomach. [4]
The minor duodenal papilla is contained within the second part of the duodenum. It is situated 2 cm proximal to the major duodenal papilla, and thus 5–8 cm from the opening of the pylorus. The gastroduodenal artery lies posterior. [1]
The horizontal part of the duodenum slopes upwards to the left of the vertical midline, following which the vertical ascending part of the duodenum reaches the transpyloric plane. [6] It ends in the duodenojejunal junction, which lies approximately 2.5 cm to the left of the midline and just below the transpyloric plane. [1]
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]
Upon dissection, the duodenum may appear to be a unified organ, but it is divided into four segments based on function, location, and internal anatomy. The four segments of the duodenum are as follows (starting at the stomach, and moving toward the jejunum): bulb, descending, horizontal, and ascending. The suspensory muscle attaches the ...
Barium X-ray examinations are useful tools for the study of appearance and function of the parts of the gastrointestinal tract. They are used to diagnose and monitor esophageal reflux, dysphagia, hiatus hernia, strictures, diverticula, pyloric stenosis, gastritis, enteritis, volvulus, varices, ulcers, tumors, and gastrointestinal dysmotility, as well as to detect foreign bodies.
The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter. [4]Its proximal supraduodenal part is situated within the free edge of the lesser omentum.Its middle retroduodenal part is oriented inferiorly and right-ward, and is situated posterior to the first part of the duodenum, and anterior to the inferior vena cava.
These include mother-baby and SpyGlass cholangioscopes (to help in diagnosis by directly visualizing the duct as opposed to only obtaining X-ray images [13] [14] [15]) as well as balloon enteroscopes (e.g. in patients that have previously undergone digestive system surgery with post-Whipple or Roux-en-Y surgical anatomy).