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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 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 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 pathogenesis of this condition is recognized to encompass stenosis or dyskinesia of the sphincter of Oddi (especially after cholecystectomy); consequently the terms biliary dyskinesia, papillary stenosis, and postcholecystectomy syndrome have all been used to describe this condition. Both stenosis and dyskinesia can obstruct flow through ...
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.
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]
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.
Kocherization of the duodenum is performed, which involves mobilisation of the duodenum to expose the distal portion of the CBD. For anastomosis to occur, the second portion of the duodenum should be placed anterior to the distal CBD. [6] An incision should be made in the hepatoduodenal ligament for the surgeon to visualise the common bile duct ...