Duodenum:

C shaped tube, about 10 inches( 25cm) long joins stomach to jejunum, receives opening of bile
and pancreatic duct, curves around head of pancreas.
Parts of Duodenum :
Situated in epigastric and umbilical regions and is divided into four parts:
First Part of Duodenum :

Begins at pylorus and runs upward and backward at the level of 1st lumbar vertebra
Relations:
Anteriorly:
Quadrate lobe of liver, gallbladder.
Posteriorly:
Lesser sac, gastroduodenal artery, bile duct, portal vein and inferior vena cava.
Superiorly:
Entrance into lesser sac.
Inferiorly :
Head of pancreas
Second Part of Duodenum :
Runs vertically downward in front of the hilum of the right kidney on the right side of the 2nd and
3rd lumbar vertebrae.
Relations :
Anteriorly :
Fundus of gallbladder, right lobe of liver, transverse colon, and coils of small intestine.
Posteriorly:
Hilum of right kidney and right ureter.
Laterally :
Ascending colon, right colic flexure, right lobe of liver.
Medially :
Head of pancreas, bile duct, main pancreatic duct.
Third Part of Duodenum :
Runs horizontally to the left of the subcostal plane passing in front of the vertebral column.
Relations :
Anteriorly :
Root of mesentery of small intestine, superior mesenteric vessels and coils of jejunum.
Posteriorly :
Right ureter, right psoas muscle, inferior vena cava and aorta.
Superiorly:
Head of pancreas
Inferiorly :
Coils of jejunum
Fourth Part of Duodenum :
Runs upward and to the left to the duodenojejunal flexure, flexure is held by peritoneal fold
ligament of Treitz which is attached to right crus of diaphragm
Relations:
Anteriorly :
Beginning of root of mesentery and coils of jejunum
Posteriorly :
Left margin of aorta, medial border of left psoas muscle.
Blood supply :
Arteries :
Upper half is supplied by the superior pancreaticoduodenal artery, a branch of the
gastroduodenal artery.
Lower half is supplied by the inferior pancreaticoduodenal artery, a branch of the superior
mesenteric artery.
Veins :
Superior pancreaticoduodenal vein drains into portal vein, inferior vein joins superior mesenteric
vein.
Lymph drainage :
Lymph vessels drain upward via pancreaticoduodenal nodes to gastroduodenal nodes and then
to celiac nodes and downward via pancreaticoduodenal nodes to superior mesenteric nodes
around origin of superior mesenteric arteries.
Nerve supply :
Derived from sympathetic and parasympathetic (vagus) nerves from celiac and superior
mesenteric plexuses.