duodenum n : the part of the small intestine between the stomach and the jejunum [also: duonas (pl), duona (pl)]
EtymologyFrom mediaeval etyl la (from the phrase |duodēnum digitōrum, in reference to its length), from duodeni.
- a UK /djuːə(ʊ)ˈdiːnəm/
first part of the small intestine
- Chinese: 十二指腸 (Shí’èrzhǐcháng)
- Czech: dvanáctník
- Danish: tolvfingertarm
- Dutch: twaalfvingerige darm , duodenum
- Finnish: pohjukaissuoli
- German: Duodenum , Zwölffingerdarm
- Japanese: 十二指腸 (じゅうにしちょう, jūnishichō)
- Korean: 십이지장 (十二指腸,sibijijang)
- Polish: dwunastnica
- Russian: двенадцатиперстная кишка (dv'enadcatip'érstnaja kišká)
In anatomy of the digestive system, the duodenum is a hollow jointed tube about 25-30 cm long connecting the stomach to the jejunum. It is the first and shortest part of the small intestine and it is where most chemical digestion takes place. It begins with the duodenal bulb and ends at the ligament of Treitz. The name duodenum is from the Latin duodenum digitorum, twelve fingers' breadths.
FunctionThe duodenum is largely responsible for the breakdown of food in the small intestine. Brunner's glands, which secrete mucus, are found in the duodenum. The duodenum wall is composed of a very thin layer of cells that form the muscularis mucosae. The duodenum is almost entirely retroperitoneal.
The duodenum also regulates the rate of emptying of the stomach via hormonal pathways. Secretin and cholecystokinin are released from cells in the duodenal epithelium in response to acidic and fatty stimuli present there when the pyloris opens and releases gastric chyme into the duodenum for further digestion. These cause the liver and gall bladder to release bile, and the pancreas to release bicarbonate and digestive enzymes such as trypsin, lipase and amylase into the duodenum as they are needed.
New studies have shown that around 80% of obese people who had gastric bypass surgery (bypassing the duodenum) were cured of their Type 2 Diabetes. However, the disappearance of their diabetes came long before the actual weight loss. When the same operation was performed on diabetic rats, they too were rid of their diabetes. However, when the operation was reversed in the animals, the diabetes returned. This shows that preventing food from entering the duodenum can have a dramatic impact on people suffering from Type 2 Diabetes.
SectionsThe duodenum is divided into four sections for the purposes of description. The first three sections form a "C" shape.
First partThe first (superior) part begins as a continuation of the duodenal end of the pylorus. From here it passes laterally (right), superiorly and posteriorly, for approximately 5 cm, before making a sharp curve inferiorly into the superior duodenal flexure (the end of the superior part). It is intraperitoneal.
Second partThe second (descending) part of the duodenum begins at the superior duodenal flexure. It passes inferiorly to the lower border of vertebral body L3, before making a sharp turn medially into the inferior duodenal flexure (the end of the descending part).
The pancreatic duct and common bile duct enter the descending duodenum, commonly known together as the hepatopancreatic duct (or pancreatic duct in the United States), through the major duodenal papilla. This part of the duodenum also contains the minor duodenal papilla, the entrance for the accessory pancreatic duct. The junction between the embryological foregut and midgut lies just below the major duodenal papilla.
Third partThe third (inferior/horizontal) part of the duodenum begins at the inferior duodenal flexure and passes transversely to the left, crossing the inferior vena cava, aorta and the vertebral column.
Fourth partThe fourth (ascending) part passes superiorly, either anterior to, or to the right of, the aorta, until it reaches the inferior border of the body of the pancreas. Then, it curves anteriorly and terminates at the duodenojejunal flexure where it joins the jejunum. The duodenojejunal flexure is surrounded by a peritoneal fold containing muscle fibres: the ligament of Treitz.
The duodenum receives arterial blood from two different sources. The transition between these sources is important as it determines the foregut from the midgut. Proximal to the 2nd part of the duodenum (approximately at the major duodenal papilla - where the bile duct enters) the arterial supply is from the gastroduodenal artery and its branch the superior pancreatoduodenal artery. Distal to this point (the midgut) the arterial supply is from the superior mesenteric artery, and its branch the inferior pancreatoduodenal artery supplies the 3rd and 4th sections. The superior and inferior pancreatoduodenal arteries (from the gastroduodenal artery and SMA respectively) form an anastomotic loop between the celiac trunk and the SMA; so there is potential for collateral circulation here.
The venous drainage of the duodenum follows the arteries. Ultimately these veins drain into the portal system, either directly or indirectly through the splenic or superior mesenteric vein.
The lymphatic vessels follow the arteries in a retrograde fashion. The anterior lymphatic vessels drain into the pancreatoduodenal lymph nodes located along the superior and inferior pancreatoduodenal arteries and then into the pyloric lymph nodes (along the gastroduodenal artery). The posterior lymphatic vessels pass posterior to the head of the pancreas and drain into the superior mesenteric lymph nodes. Efferent lymphatic vessels from the duodenal lymph nodes ultimately pass into the celiac lymph nodes.
Image:Gray1041.png |Superior and inferior duodenal fossæ. Image:Gray1050.png |Interior of the stomach. Image:Small bowel duodenum with amyloid deposition congo red 10X.jpg|Duodenum with amyloid deposition in lamina propria. Image:Illu pancrease.jpg|Region of pancreas Image:Illu stomach2.jpg|Stomach Image:Microvilli-Duodenum.JPG|Duodenum with brush border (microvillus)
duodenum in Arabic: عفج
duodenum in Bengali: ডুওডেনাম
duodenum in Catalan: Duodè
duodenum in Danish: Tolvfingertarm
duodenum in German: Duodenum
duodenum in Spanish: Duodeno
duodenum in Esperanto: Duodeno
duodenum in Persian: دوازدهه
duodenum in French: Duodénum
duodenum in Croatian: Dvanaesnik
duodenum in Indonesian: Usus dua belas jari
duodenum in Icelandic: Skeifugörn
duodenum in Italian: Duodeno
duodenum in Hebrew: תריסריון
duodenum in Javanese: Usus rolas driji
duodenum in Pampanga: Duodenum
duodenum in Latin: Duodenum
duodenum in Lithuanian: Dvylikapirštė žarna
duodenum in Hungarian: Patkóbél
duodenum in Macedonian: Дванаесетпалечно црево
duodenum in Dutch: Twaalfvingerige darm
duodenum in Japanese: 十二指腸
duodenum in Norwegian: Tolvfingertarmen
duodenum in Norwegian Nynorsk: Tolvfingertarmen
duodenum in Polish: Dwunastnica
duodenum in Portuguese: Duodeno
duodenum in Russian: Двенадцатиперстная кишка человека
duodenum in Simple English: Duodenum
duodenum in Slovak: Dvanástnik
duodenum in Slovenian: Dvanajstnik
duodenum in Serbian: Дванаестопалачно црево
duodenum in Serbo-Croatian: Dvanaesnik
duodenum in Finnish: Pohjukaissuoli
duodenum in Swedish: Tolvfingertarm
duodenum in Thai: ลำไส้เล็กส่วนต้น
duodenum in Turkish: Duodenum
duodenum in Chinese: 十二指肠
abdomen, anus, appendix, blind gut, bowels, brain, cecum, colon, endocardium, entrails, foregut, giblets, gizzard, guts, heart, hindgut, innards, inner mechanism, insides, internals, intestine, inwards, jejunum, kidney, kishkes, large intestine, liver, liver and lights, lung, midgut, perineum, pump, pylorus, rectum, small intestine, spleen, stomach, ticker, tripes, vermiform appendix, viscera, vitals, works