|ECR 2019 / C-1366|
|Guess who? Within the spectrum of duodenal pathology.|
The duodenum, the most proximal part of the small bowel, has both an extra and intraperitoneal location without mesentery. It measures about 25 cm to 30 cm in length and forms a C-loop. (1)
Consist of four parts:
- The bulb (1st portion) an intraperitoneal triangular shape segment, extends from the gastric pylorus to the gallbladder neck and suspended by the hepatoduodenal ligament. (2)
- The descending (2nd portion) goes from the superior to inferior duodenal flexure. It is the entry site of the common bile duct and the main pancreatic duct into the major papilla of Vater. (3) Fig. 1
- The transverse (3rd portion) is horizontal and extends between the aorta and the superior mesenteric vessels and in front of the inferior vena cava. (3)
- The ascending (4th portion) connects with the jejunum in the duodenojejunal flexure, suspended by ligament of Treitz.
The duodenal wall has a thickness of 2 mm and consists of 4 layers: mucosa, submucosa, circular and longitudinal smooth muscle. (4)
The primary arterial supply it is from the superior and inferior pancreaticoduodenal arteries, which are branches of the common hepatic and superior mesenteric arteries respectively. The bulb receives irrigation from the right gastric and gastroepiploic arteries.
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