Duodenum

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Duodenum
Tractus intestinalis duodenum.svg
Image of the gastrointestinal tract, with the duodenum highlighted.
Duodenumanatomy.jpg
Diagram of the human duodenum with major parts labelled
Details
Pronunciation /ˌdjuːəˈdiːnəm/ , US also /djuˈɒdɪnəm/ [1]
Precursor Foregut (1st and 2nd parts), midgut (3rd and 4th part)
Part of Small intestine
System Digestive system
Artery Inferior pancreaticoduodenal artery, superior pancreaticoduodenal artery
Vein Pancreaticoduodenal veins
Nerve Celiac ganglia, vagus [2]
Identifiers
Latin duodenum
MeSH D004386
TA98 A05.6.02.001
TA2 2944
FMA 7206
Anatomical terminology
Stomach colon rectum diagram-en.svg
Major parts of the
Gastrointestinal tract
Upper gastrointestinal tract
Lower gastrointestinal tract
See also

The duodenum is the first section of the small intestine [3] 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.

Contents

In human beings, the duodenum is a hollow jointed tube about 25–38 centimetres (10–15 inches) long connecting the stomach to the middle part of the small intestine. [4] [5] It begins with the duodenal bulb and ends at the suspensory muscle of duodenum. [6] The duodenum can be divided into four parts: the first (superior), the second (descending), the third (transverse) and the fourth (ascending) parts. [5]

Overview

The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine may be used instead of duodenum. [7] In mammals the duodenum may be the principal site for iron absorption. [8]

In humans, the duodenum is a C-shaped hollow jointed tube, 25–38 centimetres (10–15 inches) in length, lying adjacent to the stomach (and connecting it to the small intestine). It is divided anatomically into four sections. The first part lies within the peritoneum but its other parts are retroperitoneal. [9] : 273 

Parts

The first part, or superior part, of the duodenum is a continuation from the pylorus to the transpyloric plane. It is superior (above) to the rest of the segments, at the vertebral level of L1. The duodenal bulb, about 2 cm (3⁄4 in) long, is the first part of the duodenum and is slightly dilated. 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. [9] : 273 

Relations:[ citation needed ]

The second part, or descending part, of the duodenum begins at the superior duodenal flexure. It goes inferior to the lower border of vertebral body L3, before making a sharp turn medially into the inferior duodenal flexure, the end of the descending part. [9] : 274 

The pancreatic duct and common bile duct enter the descending duodenum, through the major duodenal papilla. The second part of the duodenum also contains the minor duodenal papilla, the entrance for the accessory pancreatic duct. The junction between the embryological foregut and midgut lies just below the major duodenal papilla. [9] : 274 

The third part, or horizontal part or inferior part of the duodenum is 10~12 cm in length. It begins at the inferior duodenal flexure and passes transversely to the left, passing in front of the inferior vena cava, abdominal aorta and the vertebral column. The superior mesenteric artery and vein are anterior to the third part of the duodenum. [9] : 274  This part may be compressed between the aorta and SMA causing superior mesenteric artery syndrome.

The fourth part, or ascending part, of the duodenum passes upward, joining with the jejunum at the duodenojejunal flexure. The fourth part of the duodenum is at the vertebral level L3, and may pass directly on top, or slightly to the left, of the aorta. [9] : 274 

Blood supply

The duodenum receives arterial blood from two different sources. The transition between these sources is important as it demarcates the foregut from the midgut. Proximal to the 2nd part of the duodenum (approximately at the major duodenal papilla – where the bile duct enters) the arterial supply is from the gastroduodenal artery and its branch the superior pancreaticoduodenal artery. Distal to this point (the midgut) the arterial supply is from the superior mesenteric artery (SMA), and its branch the inferior pancreaticoduodenal artery supplies the 3rd and 4th sections. The superior and inferior pancreaticoduodenal arteries (from the gastroduodenal artery and SMA respectively) form an anastomotic loop between the celiac trunk and the SMA; so there is potential for collateral circulation here.

The venous drainage of the duodenum follows the arteries. Ultimately these veins drain into the portal system, either directly or indirectly through the splenic or superior mesenteric vein and then to the portal vein.

Lymphatic drainage

The lymphatic vessels follow the arteries in a retrograde fashion. The anterior lymphatic vessels drain into the pancreatoduodenal lymph nodes located along the superior and inferior pancreatoduodenal arteries and then into the pyloric lymph nodes (along the gastroduodenal artery). The posterior lymphatic vessels pass posterior to the head of the pancreas and drain into the superior mesenteric lymph nodes. Efferent lymphatic vessels from the duodenal lymph nodes ultimately pass into the celiac lymph nodes.

Histology

Under microscopy, the duodenum has a villous mucosa. This is distinct from the mucosa of the pylorus, which directly joins the duodenum. Like other structures of the gastrointestinal tract, the duodenum has a mucosa, submucosa, muscularis externa, and adventitia. Glands line the duodenum, known as Brunner's glands, which secrete mucus and bicarbonate in order to neutralise stomach acids. These are distinct glands not found in the ileum or jejunum, the other parts of the small intestine. [11] : 274–275 

Variation

The duodenum's close anatomical association with the pancreas creates differences in function based on the position and orientation of the organs. The congenital abnormality, annular pancreas, causes a portion of the pancreas to encircle the duodenum. In an extramural annular pancreas, the pancreatic duct encircles the duodenum which results in gastrointestinal obstruction. An intramural annular pancreas is characterized by pancreatic tissue that is fused with the duodenal wall, causing duodenal ulceration. [12]

Gene and protein expression

About 20,000 protein coding genes are expressed in human cells and 70% of these genes are expressed in the normal duodenum. [13] [14] Some 300 of these genes are more specifically expressed in the duodenum with very few genes expressed only in the duodenum. The corresponding specific proteins are expressed in the duodenal mucosa, and many of these are also expressed in the small intestine, such as alanine aminopeptidase, a digestive enzyme, angiotensin-converting enzyme, involved in controlling blood pressure, and RBP2, a protein involved in the uptake of vitamin A. [15]

Function

The duodenum is largely responsible for the breakdown of food in the small intestine, using enzymes. The duodenum also regulates the rate of emptying of the stomach via hormonal pathways. Secretin and cholecystokinin are released from cells in the duodenal epithelium in response to acidic and fatty stimuli present there when the pylorus opens and emits gastric chyme into the duodenum for further digestion. These cause the liver and gallbladder to release bile, and the pancreas to release bicarbonate and digestive enzymes such as trypsin, lipase and amylase into the duodenum as they are needed. [16]

The duodenum is a critical contributor to the regulation of food intake [17] and glycemic control. [18] As the first part of the small intestine, the duodenum is the initial site of nutrient absorption in the gastrointestinal tract. The duodenum senses nutrient intake and composition, and signals to the liver, pancreas, adipose tissue and brain [19] through the direct and indirect [20] release of several key hormones and signaling molecules, including the incretin peptides Glucose-dependent insulinotropic polypeptide (GIP) and Glucagon-like peptide-1 (GLP-1), [20] as well as Cholecystokinin (CCK) and Secretin.  The duodenum also signals to the brain directly via vagal afferents enabling neural control over food intake and glycemia. [21]   Intestinal secretion of GIP and GLP-1 stimulates glucose-dependent insulin secretion from pancreatic beta-cells, known as the incretin effect. [22] Incretin peptides, principally GLP-1 and GIP, regulate islet hormone secretion, glucose concentrations, lipid metabolism, gut motility, appetite and body weight, and immune function. [23]

The villi of the duodenum have a leafy-looking appearance, which is a histologically identifiable structure. Brunner's glands, which secrete mucus, are only found in the duodenum. The duodenum wall consists of a very thin layer of cells that form the muscularis mucosae.

Clinical significance

Ulceration

Ulcers of the duodenum commonly occur because of infection by the bacteria Helicobacter pylori . These bacteria, through a number of mechanisms, erode the protective mucosa of the duodenum, predisposing it to damage from gastric acids. The first part of the duodenum is the most common location of ulcers since it is where the acidic chyme meets the duodenal mucosa before mixing with the alkaline secretions of the duodenum. [24] Duodenal ulcers may cause recurrent abdominal pain and dyspepsia, and are often investigated using a urea breath test to test for the bacteria, and endoscopy to confirm ulceration and take a biopsy. If managed, these are often managed through antibiotics that aim to eradicate the bacteria, and proton-pump inhibitors and antacids to reduce the gastric acidity. [25]

Celiac disease

The British Society of Gastroenterology guidelines specify that a duodenal biopsy is required for the diagnosis of adult celiac disease. The biopsy is ideally performed at a moment when the patient is on a gluten-containing diet. [26]

Cancer

Duodenal cancer is a cancer in the first section of the small intestine. Cancer of the duodenum is relatively rare compared to stomach cancer and colorectal cancer; malignant tumors in the duodenum constitute only around 0.3% of all the gastrointestinal tract tumors but around half of cancerous tissues that develop in the small intestine. [27] Its histology is often observed to be adenocarcinoma, meaning that the cancerous tissue arises from glandular cells in the epithelial tissue lining the duodenum. [28]

Obesity and Diabetes

A western diet induces duodenal mucosal hyperplasia and dysfunction that underlie insulin resistance, type 2 diabetes and obesity. [29] [30] Diet-induced duodenal mucosal hyperplasia consists of increased mucosal mass, [31] increased villus length, [29] [32] [33] [34] decreased crypt density, [29] proliferation of enteroendocrine cells, [35] increased enterocyte mass, [36] and an accumulation of lipid droplets in the mucosa. [37] [38] Diet induced duodenal dysfunction includes increased duodenal nutrient absorption, [32] [39] [40] [41] altered duodenal hormone secretion, [29] [35] and altered intestinal vagal afferent neuronal function. [42]

Inflammation

Inflammation of the duodenum is referred to as duodenitis. There are multiple known causes. [43] Celiac disease and inflammatory bowel disease are two of the known causes. [44]

Etymology

The name duodenum is Medieval Latin, short for intestīnum duodēnum digitōrum, meaning intestine of twelve finger-widths (in length), genitive pl. of duodēnī, twelve each, from Latin duodeni "twelve each" (from duodecim "twelve"). Coined by Gerard of Cremona (d. 1187) in his Latin translation of "Canon Avicennae," "اثنا عشر" itself a loan-translation of Greek dodekadaktylon, literally "twelve fingers long." The intestine part was so called by the Greek physician Herophilus (c. 335–280 BCE) for its length, about equal to the breadth of 12 fingers. [45]

Many languages retain a similar etymology for this word. For example, German Zwölffingerdarm, Dutch Twaalfvingerige darm and Turkish Oniki parmak bağırsağı.

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Pancreas</span> Organ of the digestive system and endocrine system of vertebrates

The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e., it has both an endocrine and a digestive exocrine function. 99% of the pancreas is exocrine and 1% is endocrine. As an endocrine gland, it functions mostly to regulate blood sugar levels, secreting the hormones insulin, glucagon, somatostatin and pancreatic polypeptide. As a part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid entering the duodenum from the stomach; and digestive enzymes, which break down carbohydrates, proteins and fats in food entering the duodenum from the stomach.

<span class="mw-page-title-main">Stomach</span> Digestive organ

The stomach is a muscular, hollow organ in the upper gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach is involved in the gastric phase of digestion, following the cephalic phase in which the sight and smell of food and the act of chewing are stimuli. In the stomach a chemical breakdown of food takes place by means of secreted digestive enzymes and gastric acid.

<span class="mw-page-title-main">Gastrointestinal tract</span> Organ system within humans and other animals

The gastrointestinal tract is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as feces. Gastrointestinal is an adjective meaning of or pertaining to the stomach and intestines.

<span class="mw-page-title-main">Small intestine</span> Organ in the gastrointestinal tract

The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pancreatic duct to aid in digestion. The small intestine is about 5.5 metres long and folds many times to fit in the abdomen. Although it is longer than the large intestine, it is called the small intestine because it is narrower in diameter.

Digestion is the breakdown of large insoluble food compounds into small water-soluble components so that they can be absorbed into the blood plasma. In certain organisms, these smaller substances are absorbed through the small intestine into the blood stream. Digestion is a form of catabolism that is often divided into two processes based on how food is broken down: mechanical and chemical digestion. The term mechanical digestion refers to the physical breakdown of large pieces of food into smaller pieces which can subsequently be accessed by digestive enzymes. Mechanical digestion takes place in the mouth through mastication and in the small intestine through segmentation contractions. In chemical digestion, enzymes break down food into the small compounds that the body can use.

<span class="mw-page-title-main">Secretin</span> Hormone involved in stomach, pancreas and liver secretions

Secretin is a hormone that regulates water homeostasis throughout the body and influences the environment of the duodenum by regulating secretions in the stomach, pancreas, and liver. It is a peptide hormone produced in the S cells of the duodenum, which are located in the intestinal glands. In humans, the secretin peptide is encoded by the SCT gene.

<span class="mw-page-title-main">Cholecystokinin</span> Hormone of the gastrointestinal system

Cholecystokinin is a peptide hormone of the gastrointestinal system responsible for stimulating the digestion of fat and protein. Cholecystokinin, formerly called pancreozymin, is synthesized and secreted by enteroendocrine cells in the duodenum, the first segment of the small intestine. Its presence causes the release of digestive enzymes and bile from the pancreas and gallbladder, respectively.

<span class="mw-page-title-main">Gastric acid</span> Digestive fluid formed in the stomach

Gastric acid or stomach acid is the acidic component – hydrochloric acid of gastric juice, produced by parietal cells in the gastric glands of the stomach lining. With a pH of between one and three, gastric acid plays a key role in the digestion of proteins by activating digestive enzymes, which together break down the long chains of amino acids of proteins. Gastric acid is regulated in feedback systems to increase production when needed, such as after a meal. Other cells in the stomach produce bicarbonate, a base, to buffer the fluid, ensuring a regulated pH. These cells also produce mucus – a viscous barrier to prevent gastric acid from damaging the stomach. The pancreas further produces large amounts of bicarbonate and secretes bicarbonate through the pancreatic duct to the duodenum to neutralize gastric acid passing into the digestive tract.

<span class="mw-page-title-main">Digestive enzyme</span> Class of enzymes

Digestive enzymes take part in the chemical process of digestion, which follows the mechanical process of digestion. Food consists of macromolecules of proteins, carbohydrates, and fats that need to be broken down chemically by digestive enzymes in the mouth, stomach, pancreas, and duodenum, before being able to be absorbed into the bloodstream. Initial breakdown is achieved by chewing (mastication) and the use of digestive enzymes of saliva. Once in the stomach further mechanical churning takes place mixing the food with secreted gastric acid. Digestive gastric enzymes take part in some of the chemical process needed for absorption. Most of the enzymatic activity, and hence absorption takes place in the duodenum.

<span class="mw-page-title-main">Gastrointestinal disease</span> Illnesses of the digestive system

Gastrointestinal diseases refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum; and the accessory organs of digestion, the liver, gallbladder, and pancreas.

<span class="mw-page-title-main">Pancreaticoduodenectomy</span> Major surgical procedure involving the pancreas, duodenum, and other organs

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.

<span class="mw-page-title-main">Incretin</span> Group of gastrointestinal hormones

Incretins are a group of metabolic hormones that stimulate a decrease in blood glucose levels. Incretins are released after eating and augment the secretion of insulin released from pancreatic beta cells of the islets of Langerhans by a blood-glucose–dependent mechanism.

<span class="mw-page-title-main">Gastric inhibitory polypeptide</span> Mammalian protein found in Homo sapiens

Gastric inhibitory polypeptide(GIP), also known as glucose-dependent insulinotropic polypeptide, is an inhibiting hormone of the secretin family of hormones. While it is a weak inhibitor of gastric acid secretion, its main role, being an incretin, is to stimulate insulin secretion.

Enteroglucagon is a peptide hormone derived from preproglucagon. It is a gastrointestinal hormone, secreted from mucosal cells primarily of the colon and terminal ileum. It consists of 37 amino acids. Enteroglucagon is released when fats and glucose are present in the small intestine; which decrease the motility to allow sufficient time for these nutrients to be absorbed.

Pancreatic juice is a liquid secreted by the pancreas, which contains a number of digestive enzymes, including trypsinogen, chymotrypsinogen, elastase, carboxypeptidase, pancreatic lipase, nucleases and amylase. The pancreas is located in the visceral region, and is a major part of the digestive system required for proper digestion and subsequent assimilation of macronutrient substances required for living.

Pancreatic diseases are diseases that affect the pancreas, an organ in most vertebrates and in humans and other mammals located in the abdomen. The pancreas plays a role in the digestive and endocrine system, producing enzymes which aid the digestion process and the hormone insulin, which regulates blood sugar levels. The most common pancreatic disease is pancreatitis, an inflammation of the pancreas which could come in acute or chronic form. Other pancreatic diseases include diabetes mellitus, exocrine pancreatic insufficiency, cystic fibrosis, pseudocysts, cysts, congenital malformations, tumors including pancreatic cancer, and hemosuccus pancreaticus.

<span class="mw-page-title-main">Glucagon-like peptide-1</span> Gastrointestinal peptide hormone involved in glucose homeostasis

Glucagon-like peptide-1 (GLP-1) is a 30- or 31-amino-acid-long peptide hormone deriving from the tissue-specific posttranslational processing of the proglucagon peptide. It is produced and secreted by intestinal enteroendocrine L-cells and certain neurons within the nucleus of the solitary tract in the brainstem upon food consumption. The initial product GLP-1 (1–37) is susceptible to amidation and proteolytic cleavage, which gives rise to the two truncated and equipotent biologically active forms, GLP-1 (7–36) amide and GLP-1 (7–37). Active GLP-1 protein secondary structure includes two α-helices from amino acid position 13–20 and 24–35 separated by a linker region.

<span class="mw-page-title-main">Enteroendocrine cell</span> Cell that produces gastrointestinal hormones

Enteroendocrine cells are specialized cells of the gastrointestinal tract and pancreas with endocrine function. They produce gastrointestinal hormones or peptides in response to various stimuli and release them into the bloodstream for systemic effect, diffuse them as local messengers, or transmit them to the enteric nervous system to activate nervous responses. Enteroendocrine cells of the intestine are the most numerous endocrine cells of the body. They constitute an enteric endocrine system as a subset of the endocrine system just as the enteric nervous system is a subset of the nervous system. In a sense they are known to act as chemoreceptors, initiating digestive actions and detecting harmful substances and initiating protective responses. Enteroendocrine cells are located in the stomach, in the intestine and in the pancreas. Microbiota play key roles in the intestinal immune and metabolic responses in these enteroendocrine cells via their fermentation product, acetate.

Gastrointestinal physiology is the branch of human physiology that addresses the physical function of the gastrointestinal (GI) tract. The function of the GI tract is to process ingested food by mechanical and chemical means, extract nutrients and excrete waste products. The GI tract is composed of the alimentary canal, that runs from the mouth to the anus, as well as the associated glands, chemicals, hormones, and enzymes that assist in digestion. The major processes that occur in the GI tract are: motility, secretion, regulation, digestion and circulation. The proper function and coordination of these processes are vital for maintaining good health by providing for the effective digestion and uptake of nutrients.

<span class="mw-page-title-main">Human digestive system</span> Digestive system in humans

The human digestive system consists of the gastrointestinal tract plus the accessory organs of digestion. Digestion involves the breakdown of food into smaller and smaller components, until they can be absorbed and assimilated into the body. The process of digestion has three stages: the cephalic phase, the gastric phase, and the intestinal phase.

References

  1. ↑ Jones, Daniel (2011). Roach, Peter; Setter, Jane; Esling, John (eds.). Cambridge English Pronouncing Dictionary (18th ed.). Cambridge University Press. ISBN   978-0-521-15255-6.
  2. ↑ Nosek, Thomas M. "Section 6/6ch2/s6ch2_30". Essentials of Human Physiology. Archived from the original on 2016-03-24.
  3. ↑ "NCI Dictionary of Cancer Terms". National Cancer Institute. Retrieved 2022-06-07. The first part of the small intestine. It connects to the stomach. The duodenum helps to further digest food coming from the stomach. It absorbs nutrients (vitamins, minerals, carbohydrates, fats, proteins) and water from food so they can be used by the body.
  4. ↑ "Duodenum: MedlinePlus Medical Encyclopedia". MedlinePlus. Retrieved 2022-06-07. It is located between the stomach and the middle part of the small intestine. After foods mix with stomach acid, they move into the duodenum, where they mix with bile from the gallbladder and digestive juices from the pancreas.
  5. 1 2 Nolan, D. J. (2002). "Radiology of the Duodenum". Radiological Imaging of the Small Intestine. Medical Radiology. Berlin, Heidelberg: Springer Berlin Heidelberg. pp. 247–259. doi:10.1007/978-3-642-56231-0_6. ISBN   978-3-642-62993-8. ISSN   0942-5373. duodenum is a C-shaped hollow organ forming an incomplete circle around the head of the pancreas. ...it is normally examined as part of the upper gastrointestinal tract.
  6. ↑ van Gijn J; Gijselhart JP (2011). "Treitz and his ligament". Ned. Tijdschr. Geneeskd. 155 (8): A2879. PMID   21557825.
  7. ↑ Guillaume, Jean; Praxis Publishing; Sadasivam Kaushik; Pierre Bergot; Robert Metailler (2001). Nutrition and Feeding of Fish and Crustaceans. Springer. p. 31. ISBN   978-1-85233-241-9 . Retrieved 2009-01-09.
  8. ↑ Latunde-Dada GO; Van der Westhuizen J; Vulpe CD; et al. (2002). "Molecular and functional roles of duodenal cytochrome B (Dcytb) in iron metabolism". Blood Cells Mol. Dis. 29 (3): 356–60. doi:10.1006/bcmd.2002.0574. PMID   12547225.
  9. 1 2 3 4 5 6 Drake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. ISBN   978-0-8089-2306-0.
  10. ↑ Singh, Inderbir; GP Pal (2012). "13". Human Embryology (9 ed.). Delhi: Macmillan Publishers India. p. 163. ISBN   978-93-5059-122-2.
  11. ↑ Deakin, Barbara Young; et al. (2006). Wheater's functional histology : a text and colour atlas (5th ed.). [Edinburgh?]: Churchill Livingstone/Elsevier. ISBN   978-0-443-06850-8.
  12. ↑ Borghei, Peyman; Sokhandon, Farnoosh; Shirkhoda, Ali; Morgan, Desiree E. (January 2013). "Anomalies, Anatomic Variants, and Sources of Diagnostic Pitfalls in Pancreatic Imaging". Radiology. 266 (1): 28–36. doi:10.1148/radiol.12112469. ISSN   0033-8419. PMID   23264525.
  13. ↑ "The human proteome in duodenum - The Human Protein Atlas". www.proteinatlas.org. Retrieved 2017-09-26.
  14. ↑ Uhlén, Mathias; Fagerberg, Linn; Hallström, Björn M.; Lindskog, Cecilia; Oksvold, Per; Mardinoglu, Adil; Sivertsson, Åsa; Kampf, Caroline; Sjöstedt, Evelina (2015-01-23). "Tissue-based map of the human proteome". Science. 347 (6220): 1260419. doi:10.1126/science.1260419. ISSN   0036-8075. PMID   25613900. S2CID   802377.
  15. ↑ Gremel, Gabriela; Wanders, Alkwin; Cedernaes, Jonathan; Fagerberg, Linn; Hallström, Björn; Edlund, Karolina; Sjöstedt, Evelina; Uhlén, Mathias; Pontén, Fredrik (2015-01-01). "The human gastrointestinal tract-specific transcriptome and proteome as defined by RNA sequencing and antibody-based profiling". Journal of Gastroenterology. 50 (1): 46–57. doi:10.1007/s00535-014-0958-7. ISSN   0944-1174. PMID   24789573. S2CID   21302849.
  16. ↑ Chandra, Rashmi; Liddle, Rodger A. (September 2014). "Recent advances in the regulation of pancreatic secretion". Current Opinion in Gastroenterology. 30 (5): 490–494. doi:10.1097/MOG.0000000000000099. ISSN   0267-1379. PMC   4229368 . PMID   25003603.
  17. ↑ Woodward, Orla R. M.; Gribble, Fiona M.; Reimann, Frank; Lewis, Jo E. (2022). "Gut peptide regulation of food intake – evidence for the modulation of hedonic feeding". The Journal of Physiology. 600 (5): 1053–1078. doi: 10.1113/JP280581 . ISSN   1469-7793. PMID   34152020.
  18. ↑ Drucker, Daniel J. (2006-03-01). "The biology of incretin hormones". Cell Metabolism. 3 (3): 153–165. doi:10.1016/j.cmet.2006.01.004. ISSN   1550-4131. PMID   16517403.
  19. ↑ Bany Bakar, Rula; Reimann, Frank; Gribble, Fiona M. (December 2023). "The intestine as an endocrine organ and the role of gut hormones in metabolic regulation". Nature Reviews Gastroenterology & Hepatology. 20 (12): 784–796. doi:10.1038/s41575-023-00830-y. ISSN   1759-5053. PMID   37626258.
  20. 1 2 Hansen, Lene; Holst, Jens J (2002-12-31). "The effects of duodenal peptides on glucagon-like peptide-1 secretion from the ileum: A duodeno–ileal loop?". Regulatory Peptides. 110 (1): 39–45. doi:10.1016/S0167-0115(02)00157-X. ISSN   0167-0115. PMID   12468108.
  21. ↑ Thorens, Bernard; Larsen, Philip Just (July 2004). "Gut-derived signaling molecules and vagal afferents in the control of glucose and energy homeostasis". Current Opinion in Clinical Nutrition & Metabolic Care. 7 (4): 471–478. doi:10.1097/01.mco.0000134368.91900.84. ISSN   1363-1950. PMID   15192452.
  22. ↑ Nauck, Michael A.; Meier, Juris J. (February 2018). "Incretin hormones: Their role in health and disease". Diabetes, Obesity and Metabolism. 20 (S1): 5–21. doi:10.1111/dom.13129. ISSN   1462-8902. PMID   29364588.
  23. ↑ Campbell, Jonathan E.; Drucker, Daniel J. (2013-06-04). "Pharmacology, physiology, and mechanisms of incretin hormone action". Cell Metabolism. 17 (6): 819–837. doi:10.1016/j.cmet.2013.04.008. ISSN   1932-7420. PMID   23684623.
  24. ↑ Smith, Margaret E. The Digestive System.
  25. ↑ Colledge, Nicki R.; Walker, Brian R.; Ralston, Stuart H., eds. (2010). Davidson's principles and practice of medicine (21st ed.). Edinburgh: Churchill Livingstone/Elsevier. pp. 871–874. ISBN   978-0-7020-3085-7.
  26. ↑ Ludvigsson, J. F.; Bai, J. C.; Biagi, F.; Card, T. R.; Ciacci, C.; Ciclitira, P. J.; Green, P. H. R.; Hadjivassiliou, M.; Holdoway, A.; van Heel, D. A.; Kaukinen, K.; Leffler, D. A.; Leonard, J. N.; Lundin, K. E. A.; McGough, N.; Davidson, M.; Murray, J. A.; Swift, G. L.; Walker, M. M.; Zingone, F.; Sanders, D. S. (2014). "Diagnosis and management of adult coeliac disease: Guidelines from the British Society of Gastroenterology". Gut. 63 (8): 1210–1228. doi:10.1136/gutjnl-2013-306578. ISSN   0017-5749. PMC   4112432 . PMID   24917550.
  27. ↑ Fagniez, Pierre-Louis; Rotman, Nelly (2001). Malignant tumors of the duodenum. Zuckschwerdt.
  28. ↑ "Definition of adenocarcinoma - NCI Dictionnary of Cancer Terms". National Cancer Institute. Retrieved 12 July 2024.
  29. 1 2 3 4 Aliluev, Alexandra; Tritschler, Sophie; Sterr, Michael; Oppenländer, Lena; Hinterdobler, Julia; Greisle, Tobias; Irmler, Martin; Beckers, Johannes; Sun, Na; Walch, Axel; Stemmer, Kerstin; Kindt, Alida; Krumsiek, Jan; Tschöp, Matthias H.; Luecken, Malte D. (2021-09-22). "Diet-induced alteration of intestinal stem cell function underlies obesity and prediabetes in mice". Nature Metabolism. 3 (9): 1202–1216. doi:10.1038/s42255-021-00458-9. ISSN   2522-5812. PMC   8458097 . PMID   34552271.
  30. ↑ Clara, Rosmarie; Schumacher, Manuel; Ramachandran, Deepti; Fedele, Shahana; Krieger, Jean-Philippe; Langhans, Wolfgang; Mansouri, Abdelhak (January 2017). "Metabolic Adaptation of the Small Intestine to Short- and Medium-Term High-Fat Diet Exposure: INTESTINAL METABOLIC ADAPTATION TO HFD". Journal of Cellular Physiology. 232 (1): 167–175. doi:10.1002/jcp.25402. PMID   27061934.
  31. ↑ Hvid, Henning; Jensen, Stina Rikke; Witgen, Brent M.; Fledelius, Christian; Damgaard, Jesper; Pyke, Charles; Rasmussen, Thomas Bovbjerg (2016). "Diabetic Phenotype in the Small Intestine of Zucker Diabetic Fatty Rats". Digestion. 94 (4): 199–214. doi:10.1159/000453107. ISSN   0012-2823. PMID   27931035.
  32. 1 2 Taylor, Samuel R.; Ramsamooj, Shakti; Liang, Roger J.; Katti, Alyna; Pozovskiy, Rita; Vasan, Neil; Hwang, Seo-Kyoung; Nahiyaan, Navid; Francoeur, Nancy J.; Schatoff, Emma M.; Johnson, Jared L.; Shah, Manish A.; Dannenberg, Andrew J.; Sebra, Robert P.; Dow, Lukas E. (2021-09-09). "Dietary fructose improves intestinal cell survival and nutrient absorption". Nature. 597 (7875): 263–267. doi:10.1038/s41586-021-03827-2. ISSN   0028-0836. PMC   8686685 . PMID   34408323.
  33. ↑ Dailey, Megan J. (September 2014). "Nutrient-induced intestinal adaption and its effect in obesity". Physiology & Behavior. 136: 74–78. doi:10.1016/j.physbeh.2014.03.026. PMC   4182169 . PMID   24704111.
  34. ↑ Sagher, F. A.; Dodge, J. A.; Johnston, C. F.; Shaw, C.; Buchanan, K. D.; Carr, K. E. (1991). "Rat small intestinal morphology and tissue regulatory peptides: effects of high dietary fat". British Journal of Nutrition. 65 (1): 21–28. doi:10.1079/BJN19910062. ISSN   0007-1145. PMID   1705145.
  35. 1 2 Gniuli, D.; Calcagno, A.; Dalla Libera, L.; Calvani, R.; Leccesi, L.; Caristo, M. E.; Vettor, R.; Castagneto, M.; Ghirlanda, G.; Mingrone, G. (October 2010). "High-fat feeding stimulates endocrine, glucose-dependent insulinotropic polypeptide (GIP)-expressing cell hyperplasia in the duodenum of Wistar rats". Diabetologia. 53 (10): 2233–2240. doi:10.1007/s00125-010-1830-9. ISSN   0012-186X. PMID   20585935.
  36. ↑ Verdam, Froukje J.; Greve, Jan Willem M.; Roosta, Sedigheh; van Eijk, Hans; Bouvy, Nicole; Buurman, Wim A.; Rensen, Sander S. (2011-02-01). "Small Intestinal Alterations in Severely Obese Hyperglycemic Subjects". The Journal of Clinical Endocrinology & Metabolism. 96 (2): E379 –E383. doi:10.1210/jc.2010-1333. ISSN   0021-972X. PMID   21084402.
  37. ↑ Sferra, Roberta; Pompili, Simona; Cappariello, Alfredo; Gaudio, Eugenio; Latella, Giovanni; Vetuschi, Antonella (2021-07-06). "Prolonged Chronic Consumption of a High Fat with Sucrose Diet Alters the Morphology of the Small Intestine". International Journal of Molecular Sciences. 22 (14): 7280. doi: 10.3390/ijms22147280 . ISSN   1422-0067. PMC   8303301 . PMID   34298894.
  38. ↑ D’Aquila, Theresa; Zembroski, Alyssa S.; Buhman, Kimberly K. (2019-03-05). "Diet Induced Obesity Alters Intestinal Cytoplasmic Lipid Droplet Morphology and Proteome in the Postprandial Response to Dietary Fat". Frontiers in Physiology. 10: 180. doi: 10.3389/fphys.2019.00180 . ISSN   1664-042X. PMC   6413465 . PMID   30890954.
  39. ↑ Dyer, J.; Wood, I. S.; Palejwala, A.; Ellis, A.; Shirazi-Beechey, S. P. (2002-02-01). "Expression of monosaccharide transporters in intestine of diabetic humans". American Journal of Physiology-Gastrointestinal and Liver Physiology. 282 (2): G241 –G248. doi:10.1152/ajpgi.00310.2001. ISSN   0193-1857.
  40. ↑ Fiorentino, Teresa Vanessa; Suraci, Evelina; Arcidiacono, Gaetano Paride; Cimellaro, Antonio; Mignogna, Chiara; Presta, Ivan; Andreozzi, Francesco; Hribal, Marta Letizia; Perticone, Francesco; Donato, Giuseppe; Luzza, Francesco; Sesti, Giorgio (2017-11-01). "Duodenal Sodium/Glucose Cotransporter 1 Expression Under Fasting Conditions Is Associated With Postload Hyperglycemia". The Journal of Clinical Endocrinology & Metabolism. 102 (11): 3979–3989. doi:10.1210/jc.2017-00348. ISSN   0021-972X.
  41. ↑ Fiorentino, Teresa Vanessa; De Vito, Francesca; Suraci, Evelina; Marasco, Raffaella; Hribal, Marta Letizia; Luzza, Francesco; Sesti, Giorgio (March 2023). "Obesity and overweight are linked to increased sodium‐glucose cotransporter 1 and glucose transporter 5 levels in duodenum". Obesity. 31 (3): 724–731. doi:10.1002/oby.23653. ISSN   1930-7381.
  42. ↑ de Lartigue, Guillaume; Barbier de la Serre, Claire; Espero, Elvis; Lee, Jennifer; Raybould, Helen E. (2012-03-07). Gaetani, Silvana (ed.). "Leptin Resistance in Vagal Afferent Neurons Inhibits Cholecystokinin Signaling and Satiation in Diet Induced Obese Rats". PLOS ONE. 7 (3): e32967. doi: 10.1371/journal.pone.0032967 . ISSN   1932-6203. PMC   3296757 . PMID   22412960.
  43. ↑ Serra S, Jani PA (2006). "An approach to duodenal biopsies". J. Clin. Pathol. 59 (11): 1133–50. doi:10.1136/jcp.2005.031260. PMC   1860495 . PMID   16679353.
  44. ↑ Alper, Arik; Hardee, Steven; Rojas-velasquez, Danilo; Escalera, Sandra; Morotti, Raffaella A; Pashankar, Dinesh S. (February 2016). "Prevalence, clinical, endoscopic and pathological features of duodenitis in children". Journal of Pediatric Gastroenterology and Nutrition. 62 (2): 314–316. doi:10.1097/MPG.0000000000000942. ISSN   0277-2116. PMC   4724230 . PMID   26252915.
  45. ↑ "duodenum - Origin and meaning of duodenum by Online Etymology Dictionary". www.etymonline.com.
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