Duodenum

Duodenum structure

The duodenum (duodeyonum) is initial department of a small intestine, follows right after a pylorus (pylorus). Then this department of intestines goes from left to right and several kzada, turns down, goes down along a front surface of a right kidney, turns to the left and, rising slantwise up, passes into a jejunum. The name of this department of intestines is connected with its length making twelve diameters of fingers of a hand.

The anatomy of a duodenum is closely connected with zhelchevydelitelny system, and also a pancreas. On an internal surface of the descending department of a duodenum the nipple is located fater (or a big duodenal nipple). Here through Oddi's sphincter the general bilious channel, a pancreat duct (at some people the pancreat duct can directly fall into the general bilious canal) opens. 8-40 mm above a big duodenal nipple the small duodenal nipple is located. Through it the additional pancreat duct opens. This structure is anatomically variable.

The histologic structure of a mucous membrane of a duodenum provides resistance of its epithelium to aggressive structure of a gastric juice, bile, pancreatic enzymes.

Functions of a duodenum

One of the main functions of a duodenum is reduction of pH of the food gruel arriving from a stomach to alkaline which will not irritate distal departments of intestines and is suitable for implementation of processes of pristenochny digestion. In this department of intestines processes of intestinal digestion begin.

The second important function of a duodenum is initiation and regulation of enzymatic activity of the pancreas and liver depending on chemical composition and acidity of the arriving food gruel.

The third function of a duodenum is the regulation of reflex opening and closing of a pylorus depending on acidity and chemical composition of contents of this department of intestines and also regulation of acidity of a gastric juice thanks to secretion of the humoral factors providing secretory activity of a stomach.

Duodenum diseases

The most frequent diseases of a duodenum are a duodenum inflammation (duodenitis), a duodenum ulcer, oncological diseases (duodenum cancer).

Duodenitis

The duodenitis is an inflammation of a duodenum, namely her mucous membrane. Food toxicoinfections, poisonings with toxic substances which annoyingly influence on mucous a GIT, the excessive use of spicy food, especially in combination with alcohol, injury of a mucous membrane by foreign bodys are the reason of development of a duodenitis.

Such symptoms as pain in epigastriums, weakness, nausea, vomiting, fervescence are characteristic of an inflammation of a duodenum. The catarral and erosive and ulcer form of a duodenitis usually within several days comes to an end with self-healing, at repeated defeat process synchronization is possible. Development of acute pancreatitis, intestinal bleeding, perforation of a wall of a duodenum belong to complications of a duodenitis.

Treatment of a duodenitis consists in an adequate dietotherapy, reception of the knitting and enveloping drugs, spasmolysants and cholinolytics.

Duodenum ulcer

The ulcer of a duodenum develops as a result of influence of a helikobakterny infection. Hereditary factors, psychological features of the person, a food factor, influence of medicines, addictions contribute to development of this pathology. Symptoms of this disease are pain in epigastriums in several hours after meal, night epigastric pains, heartburn, nausea, vomiting. Bleeding, a penetration, a malignancy (development of malignant defeat), a pyloric stenosis, and also perforation of a wall of a duodenum belong to complications of a disease.

Treatment consists in reception of antikhelikobakterny means (antibiotics, bismuth drugs), symptomatic therapy, a dietotherapy.

Duodenum cancer

Cancer of a duodenum is most often localized in okolososochkovy area (the descending department), is more rare – in an upper or lower horizontal part. Duodenal cancer, unlike a carcinoma of the stomach, is characterized by low tendency to formation of metastasises. It is usually limited to damage of regional lymph nodes. Feature of a clinical picture of cancer of duodenum is that the tumor of the small sizes does not give symptoms as does not complicate passing of intestinal contents and does not cause intoxication. Therefore, symptoms arise at sufficient increase in a tumor and a prelum by a number of the located bodies. There are symptoms connected with the complicated intake of bile in intestines: pain in right hypochondrium, nausea, a loss of appetite. At a prelum of a pancreat duct pancreatitis of various degrees of severity develops. At tumors of the large sizes the clinic is connected with the stenosis phenomena: nausea, intestines swelling, overflow of a stomach, an eructation, heartburn is characteristic. Such general are characteristic a symptom as weight reduction, anemia, appetite disturbance. Successful treatment depends on timely diagnosis of cancer of duodenum. Treatment of this pathology operational – a circular resection of the struck department of a gut, at peripapillary cancer is also removed a big duodenal nipple, a pancreat duct.