Topography duodenal ulcers: 1 - liver; 2 - pancreas, 3, 4, 6 and 9-rising (3), lower (4), downward(6), top (9) part of the duodenum; 5 - big nipple duodenal ulcers; 7 - longitudinal crease; 8 - small nipple duodenal ulcers; 10 - the common bile duct.

Duodenal intestine (duodenum) - the initial part of the small intestine, the following directly behind the stomach. By the end of the duodenum is dvenadtsatiperstnoi-toxicisity bending. The length of the colon 25-30 cm, diameter of about 5 see Duodenum u covers the head of the pancreas (Fig.). There are four parts of the duodenum. The upper part is a continuation privratnika Department of the stomach. Due to a sharp bend it clearly delineated from the next part; when ray study of the upper part of the duodenum has the form of a ball, and therefore it is also called the onion duodenum. Further, there is a descending part, continued in the lower horizontal and the ascending part. The latter passes the jejunum. On the medial side of the descending part is a large (Federov) nipple duodenal ulcer in this place, it opened the common bile duct and the pancreatic duct. Slightly higher big nipple duodenum is small nipple, where there mouth existing in some cases, incremental pancreatic duct.
The blood supply of the duodenum in common with the head of the pancreas and is carried out by branches of the celiac trunk and superior mesenteric artery. Vienna duodenum into the portal vein.
Innerviruetsya duodenum branches celiac and superior mesenteric plexus and wandering nerves.
The duodenal wall consists of mucous membrane, submucosal layer, muscle and serous membranes (in the area covered by the peritoneum). In the submucosal layer, especially in the initial part 12 duodenal ulcer, duodenal are (brunnerova) cancer (in structure and function is similar to the pyloric glands), and plexus arteries, veins, and lymphatic capillaries and blood vessels and submucosal nerve plexus (Meissner).
Muscular layer of the walls of the duodenum formed inner circular and outer longitudinal layer. Between them is located intermuscular nerve plexus (Auerbach).
Physiology duodenum - see Digestion.
Research methods. The main method of investigation is x-ray detecting peptic ulcer disease, diverticula, stenosis, tumors 12 duodenal ulcer. Preparation of the patient for x-ray studies: cleansing enema the day before in the evening and the day of the examination. The patient before the test should not eat, drink and drugs, and Smoking. To explore the content of the duodenum used duodenal intubation (see).
Malformations of the duodenum occur rarely. They can be divided into two groups. The first is atresia - the complete absence of bowel lumen and its narrowing (stenosis) of different degree, usually localized above the big nipple duodenum. Intestine, situated above the defect, greatly expanded and thinned. Vomiting "fountain" appears in the first hours of life. Sooner comes progressive depletion. The diagnosis is simple. Should be excluded pilorospazm, which vomiting appears much later, no progressive depletion, in vomitus usually present bile. The forecast is bad when there atresia and pronounced stenosis. A child dies in the first week of life. Treatment: urgent surgical intervention.
The second group relates to the excessive development of duodenal ulcer - megabalanus. It occurs very rarely and may be asymptomatic. Profuse vomiting mixed with bile and pancreatic juice arise during the development of a highly elongated intestine inflammation (duodenitis, perioodina), the occurrence of ulcers, diverticulum. Operative treatment.

  • Diseases of the duodenum