Major duodenal papilla

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Major duodenal papilla
Gray1057.png
Interior of the descending portion of the duodenum, showing bile papilla.
Gray1100.png
The pancreatic duct.
Details
Latin papilla duodeni major
Identifiers
Dorlands
/Elsevier
p_03/12610350
TA A05.6.02.015
FMA FMA:15074
Anatomical terminology

The major duodenal papilla is an opening of the pancreatic duct into the duodenum. The major duodenal papilla is, in most people, the primary mechanism for the secretion of bile and other enzymes that facilitate digestion.

Structure[edit]

1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6. Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla
9. Gallbladder, 10–11. Right and left lobes of liver. 12. Spleen.
13. Esophagus. 14. Stomach. Small intestine: 15. Duodenum, 16. Jejunum
17. Pancreas: 18: Accessory pancreatic duct, 19: Pancreatic duct.
20–21: Right and left kidneys (silhouette).
The anterior border of the liver is lifted upwards (brown arrow). Gallbladder with Longitudinal section, pancreas and duodenum with frontal one. Intrahepatic ducts and stomach in transparency.

The major duodenal papilla is situated in the second part of the duodenum, 7-10 cm from the pylorus, at the level of the second or third lumbar vertebrae. It is surrounded by the sphincter of Oddi, and receives a mixture of pancreatic enzymes and bile from the Ampulla of Vater, which drains both the pancreatic duct and biliary system. [1] The junction between the foregut and midgut occurs directly below the major duodenal papilla. [2]:274

The major duodenal papilla is seen from the duodenum as lying within a mucosal fold. The minor duodenal papilla is situated 2cm proximal. [1]

Variation[edit]

The major duodenal papilla is occasionally found in the third part of the duodenum, the level of the vertebrae may be L2-3, and in about 10% of people, it may not receive bile. Additionally, in a small amount of people, the primary papilla for draining the pancreas may in fact be the accessory pancreatic duct. [1]

Clinical significance[edit]

History[edit]

The major duodenal papilla was first illustrated by Gottfreid Bidloo in 1685, although is sometimes called the papilla of Vater, after German anatomist Abraham Vater. [1]

See also[edit]

This article uses anatomical terminology; for an overview, see anatomical terminology.

External links[edit]

References[edit]

This article incorporates text from a public domain edition of Gray's Anatomy.

  1. ^ a b c d Skandalakis, editor in chief John E. (2004). Skandalakis' surgical anatomy : the embryologic and anatomic basis of modern surgery. Athens, Greece: PMP. pp. Chapter 16: Small Intestine; Chapter 21:Pancreas, sections titled "Major duodenal papilla". ISBN 9603990744. 
  2. ^ Drake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. ISBN 978-0-8089-2306-0.