Major duodenal papilla

Major duodenal papilla
Major duodenal papilla
	Interior of the descending portion of the duodenum, showing bile papilla.
	The pancreatic duct.
Details
Identifiers
Latin	papilla duodeni major
TA98	A05.6.02.015
TA2	2955
FMA	15074
	Anatomical terminology [edit on Wikidata]

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

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. ^[2] The junction between the foregut and midgut occurs directly below the major duodenal papilla. ^[3]^: 274

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

Variation

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. ^[2]

Clinical significance

History

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. ^[2]

External links

pancreas at The Anatomy Lesson by Wesley Norman (Georgetown University)
digest-019—Embryo Images at University of North Carolina
Swiss embryology (from UL, UB, and UF) sdigestive/pankreas01

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

^ Standring S, Borley NR, eds. (2008). Gray's anatomy : the anatomical basis of clinical practice. Brown JL, Moore LA (40th ed.). London: Churchill Livingstone. pp. 1163, 1177, 1185–6. ISBN 978-0-8089-2371-8.
^ ^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. {{cite book}}: |first= has generic name (help)
^ Drake, Richard L. (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. ISBN 978-0-8089-2306-0. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

[1] Standring S, Borley NR, eds. (2008). Gray's anatomy : the anatomical basis of clinical practice. Brown JL, Moore LA (40th ed.). London: Churchill Livingstone. pp. 1163, 1177, 1185–6. ISBN 978-0-8089-2371-8.

[Skandalakis2004-2] 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. {{cite book}}: |first= has generic name (help)

[GRAYS2005-3] Drake, Richard L. (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. ISBN 978-0-8089-2306-0. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

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