Options and anomalies of the duodenum

Anomalies in the size and position of the duodenum occur rarely. These are increased smexiest and education incremental loops (the so-called duodenum mobile), which arise from the presence of the mesentery and intraperitonealno the layout of the entire colon. At long loops, on the grounds of stagnation in their gastric weight, can develop duodenostaza or formed twisting loops. It creates a painful condition that can simulate organic suffering the duodenum or the adjacent organs.
Unusual petitot can be produced in wretched conditions duodenal intestine (duodenum inversum), when the lower part is not recorded under the stomach, and goes to the right, here connecting with the jejunum.
Other anomalies deserve special attention diverticula. Lifetime recognition of this anomaly can only radiographically. As representatives of anomalies can be considered only congenital diverticula, which, as a rule, portsionnye, i.e., appearing with increasing intestinal pressure. As shown postmortem studies, such diverticula in most cases, represent a kind of hernia mucosa that fall through the cracks muscles bowel. True diverticula, consisting of all layers of the intestinal wall, occur extremely rarely. Diverticula, forms around of Vater nipple, can have their source, being implemented in the intestine wall, the pancreatic islets.
Currently believe that diverticula the field of Vater nipple may arise from pathological changes of the pancreas, as they are often accompanied by chronic pancreatitis (9% according to our data). Diverticula duodenal ulcers, who met earlier as a rarity, now recognized very often (4%) with normal chest x-ray studies of the gastrointestinal tract.
Are diverticula mainly on the inner surface of the duodenum, meeting here as a single, and as a multiple of education. Very rarely you can define them on the outer surface. The largest number of diverticula is found near the location of Vater's nipple. Radiographically they represent a rounded, less oval education with a leg of different lengths (Fig. 97, a, b).

Fig. 97. Diverticula duodenum (x-rays).
about - multiple diverticula on the inner wall (arrow); b - great diverticulum on the outer wall (arrow).

Sometimes as a congenital disease or on the grounds of constitutional deviations develops arteriomesenterial obstruction, causing phenomena stasis due to the overlapping of the large intestine mesenteric vessels and close fit to the lower part of the duodenum. Radiographically this disease manifests itself first of all in violation of porozhdaemom stomach. Above narrow the intestine is stretched and found antiperistaltic movements. The contours of the walls of the duodenum smooth, without the typical poristosti. Lower division widely stretched, is also expanding and onion duodenum, the porter gaping.