THE DUODENUM

• Duodenum
• The first part of the small intestine.
• Has a C-shaped structure.
• Adjacent to the head of the pancreas.
• is 20-25 cm long
• is above the level of the umbilicus
• its lumen is the widest of the small
intestine.
• Retroperitoneal except for its
beginning
• connected to the liver by the
hepatoduodenal ligament
• a part of the lesser omentum.
• The duodenum is divided into four parts.
• the superior part (first part)
• extends from the pyloric orifice of the
stomach to the neck of the gallbladder
• to the right of the body of vertebra LI
• Passes anteriorly to the
• bile duct
• gastroduodenal artery
• portal vein
• and inferior vena cava
• Clinically, the beginning of this part of the
duodenum is referred to as the ampulla or
duodenal cap
• most duodenal ulcers occur in this part of the
duodenum;
• the descending part (second part)
• just to the right of midline
• Extends from the neck of the gallbladder to
the lower border of vertebra LIII
• its anterior surface is crossed by the
transverse colon
• posterior to it is the right kidney
• and medial to it is the head of the pancreas
• -this part of the duodenum contains the major
duodenal papilla
• the common entrance for the bile and
pancreatic ducts
• and the minor duodenal papilla
• the entrance for the accessory pancreatic duct
• the junction of the foregut and the midgut
• just below the major duodenal papilla;
• the inferior part (third part)
• the longest section
• crosses
• the inferior vena cava
• the aorta
• and the vertebral column
• Crossed anteriorly by the superior
mesenteric artery and vein;
• The ascending part (fourth part)
• Passes upward on to the left of the aorta
• To approximately the upper border of
vertebra LII
• And terminates at the duodenojejunal
flexure.
• surrounded by a fold of peritoneum
containing muscle fibers called the
suspensory muscle (ligament) of
duodenum (ligament of Treitz).