| Duodenal bulb | |
|---|---|
 | |
| Details | |
| Identifiers | |
| Latin | ampulla duodeni, [1] bulbus duodeni [1] |
| Anatomical terminology | |
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. [2]
It is located posterior to the liver and the gallbladder and superior to the pancreatic head.[ citation needed ] The gastroduodenal artery, [3] portal vein, and common bile duct are situated posterior to the duodenal bulb. The distal part of the bulb is located retroperitoneally. It is located immediately distal to the pyloric sphincter.[ citation needed ]
The duodenal bulb is the site of duodenal ulcer occurrence. Duodenal ulcers are more common than gastric ulcers and - unlike gastric ulcers - are caused by increased gastric acid secretion. Duodenal ulcers are commonly located anteriorly, and rarely posteriorly. Anterior ulcers can be complicated by perforation, while the posterior ones bleed. The reason for that is explained by their location. The peritoneal or abdominal cavity is located anterior to the duodenum. Therefore, if the ulcer grows deep enough, it will perforate, whereas if a posterior ulcer grows deep enough, it will penetrate the gastroduodenal artery and bleed.[ citation needed ]
The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In mammals, it may be the principal site for iron absorption. The duodenum precedes the jejunum and ileum and is the shortest part of the small intestine.
The bile duct is a part of the biliary tract. It is formed by the union of the common hepatic duct and cystic duct. It ends by uniting with the pancreatic duct to form the hepatopancreatic ampulla. It possesses its sphincter to enable the regulation of bile flow.
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta.
A pancreaticoduodenectomy, also known as a Whipple procedure, is a major surgical operation most often performed to remove cancerous tumours from the head of the pancreas. It is also used for the treatment of pancreatic or duodenal trauma, or chronic pancreatitis. Due to the shared blood supply of organs in the proximal gastrointestinal system, surgical removal of the head of the pancreas also necessitates removal of the duodenum, proximal jejunum, gallbladder, and, occasionally, part of the stomach.
In anatomy, the gastroduodenal artery is a small blood vessel in the abdomen. It supplies blood directly to the pylorus and proximal part of the duodenum. It also indirectly supplies the pancreatic head.
In human anatomy, the left gastric artery arises from the celiac artery and runs along the superior portion of the lesser curvature of the stomach before anastomosing with the right gastric artery. It also issues esophageal branches that supply lower esophagus and ascend through the esophageal hiatus to form anastomoses with the esophageal branches of thoracic part of aorta.
The hepatic artery proper is the artery that supplies the liver and gallbladder. It raises from the common hepatic artery, a branch of the celiac artery.
The cystic artery is (usually) a branch of the right hepatic artery that provides arterial supply to the gallbladder and contributes arterial supply to the extrahepatic bile ducts.
The superior pancreaticoduodenal artery is an artery that supplies blood to the duodenum and pancreas.
The foregut in humans is the anterior part of the alimentary canal, from the distal esophagus to the first half of the duodenum, at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. The foregut arises from the endoderm, developing from the folding primitive gut, and is developmentally distinct from the midgut and hindgut. Although the term “foregut” is typically used in reference to the anterior section of the primitive gut, components of the adult gut can also be described with this designation. Pain in the epigastric region, just below the intersection of the ribs, typically refers to structures in the adult foregut.
In anatomy, arterial tree is used to refer to all arteries and/or the branching pattern of the arteries. This article regards the human arterial tree. Starting from the aorta:
Gastric outlet obstruction (GOO) is a medical condition where there is an obstruction at the level of the pylorus, which is the outlet of the stomach. Individuals with gastric outlet obstruction will often have recurrent vomiting of food that has accumulated in the stomach, but which cannot pass into the small intestine due to the obstruction. The stomach often dilates to accommodate food intake and secretions. Causes of gastric outlet obstruction include both benign causes, such as peptic ulcer disease affecting the area around the pylorus, and malignant causes, such as gastric cancer.
The hepatic plexus is a sympathetic and parasympathetic nerve plexus that provides innervation to the parenchyma of the liver as well as contributing innervation to some other abdominal structures.
Hemosuccus pancreaticus is a rare cause of hemorrhage in the gastrointestinal tract. It is caused by a bleeding source in the pancreas, pancreatic duct, or structures adjacent to the pancreas, such as the splenic artery, that bleed into the pancreatic duct, which is connected with the bowel at the duodenum, the first part of the small intestine. Patients with hemosuccus may develop symptoms of gastrointestinal hemorrhage, such as blood in the stools, maroon stools, or melena, which is a dark, tarry stool caused by digestion of red blood cells. They may also develop abdominal pain. It is associated with pancreatitis, pancreatic cancer and aneurysms of the splenic artery. Hemosuccus may be identified with endoscopy (esophagogastroduodenoscopy), where fresh blood may be seen from the pancreatic duct. Alternatively, angiography may be used to inject the celiac axis to determine the blood vessel that is bleeding. This may also be used to treat hemosuccus, as embolization of the end vessel may terminate the hemorrhage. However, a distal pancreatectomy—surgery to remove of the tail of the pancreas—may be required to stop the hemorrhage.
The membranous urethra or intermediate part of male urethra is the shortest, least dilatable, and, with the exception of the urinary meatus, the narrowest part of the urethra. It extends from the apex of the prostate proximally to the bulb of urethra distally. It measures some 12 mm in length. It traverses the pelvic floor. It is surrounded by the external urethral sphincter, which is in turn envelopped by the superior fascia of the urogenital diaphragm.
The anterior vagal trunk is one of the two divisions into which the vagus nerve splits as it passes through the esophageal hiatus to enter the abdominal cavity. The anterior and posterior vagal trunks represent the inferior continuation of the esophageal nervous plexus inferior to the diaphragm. The majority of nerve fibres in the anterior vagal trunk are derived from the left vagus nerve.
Superior mesenteric artery (SMA) syndrome is a gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery. This rare, potentially life-threatening syndrome is typically caused by an angle of 6–25° between the AA and the SMA, in comparison to the normal range of 38–56°, due to a lack of retroperitoneal and visceral fat. In addition, the aortomesenteric distance is 2–8 millimeters, as opposed to the typical 10–20. However, a narrow SMA angle alone is not enough to make a diagnosis, because patients with a low BMI, most notably children, have been known to have a narrow SMA angle with no symptoms of SMA syndrome.
Choledochoduodenostomy (CDD) is a surgical procedure to create an anastomosis, a surgical connection, between the common bile duct (CBD) and an alternative portion of the duodenum. In healthy individuals, the CBD meets the pancreatic duct at the ampulla of Vater, which drains via the major duodenal papilla to the second part of duodenum. In cases of benign conditions such as narrowing of the distal CBD or recurrent CBD stones, performing a CDD provides the diseased patient with CBD drainage and decompression. A side-to-side anastomosis is usually performed.
Antrectomy, also called distal gastrectomy, is a type of gastric resection surgery that involves the removal of the stomach antrum to treat gastric diseases causing the damage, bleeding, or blockage of the stomach. This is performed using either the Billroth I (BI) or Billroth II (BII) reconstruction method. Quite often, antrectomy is used alongside vagotomy to maximise its safety and effectiveness. Modern antrectomies typically have a high success rate and low mortality rate, but the exact numbers depend on the specific conditions being treated.
