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From Digestive System
Duodenal Bulb
Initial section of duodenum closest to the stomach.
Overview
The duodenal bulb, also known as the duodenal cap, is the first portion of the duodenum—the initial segment of the small intestine. It plays a transitional role between the stomach and the rest of the duodenum, serving as a site where chyme is received from the stomach and neutralized before progressing further along the intestinal tract. The duodenal bulb is an important anatomical landmark and a frequent site of peptic ulcer disease.
Location
The duodenal bulb is located in the epigastric region of the abdomen. It:
Begins at the pylorus of the stomach
Extends approximately 2–5 cm before turning downward at the superior duodenal flexure
Lies anterolateral to the L1 vertebral body, and is intraperitoneal in contrast to the rest of the duodenum, which is retroperitoneal
Is located anterior to the gastroduodenal artery, portal vein, and common bile duct
Structure
The duodenal bulb has structural features that distinguish it from other parts of the duodenum:
Mucosa: Lined with simple columnar epithelium containing villi and mucus-secreting goblet cells
Submucosa: Contains connective tissue, lymphatics, and blood vessels; more prone to Brunner’s glands in distal sections
Muscularis externa: Includes inner circular and outer longitudinal smooth muscle layers for peristalsis
Serosa: As it is intraperitoneal, the bulb is covered by a serosal layer derived from the peritoneum
The bulb appears smooth radiologically (especially on barium studies) compared to the more feathery appearance of the distal duodenum.
Function
The duodenal bulb performs several essential functions:
Receives chyme: Acts as the first site to receive acidic gastric contents from the stomach
Initial neutralization: Begins the process of pH buffering to protect the intestinal mucosa
Transit regulation: Coordinates the release of chyme into the descending duodenum in a controlled manner
Physiological Role(s)
The duodenal bulb contributes to digestive physiology in multiple ways:
pH buffering: Mucosal secretions and nearby Brunner’s glands release alkaline mucus to neutralize gastric acid
Hormonal regulation: Stimulates release of hormones such as secretin and cholecystokinin (CCK) in response to acidic and fatty chyme
Digestive enzyme activation: Sets the stage for pancreatic enzyme activity by adjusting luminal pH
Protective interface: Acts as a buffer zone to reduce chemical injury to the more distal small intestine
Clinical Significance
The duodenal bulb is a frequent site of gastrointestinal pathology and is important in clinical diagnostics:
Duodenal ulcers: The most common location for peptic ulcers, often due to Helicobacter pylori infection or NSAID use; can cause bleeding or perforation
Duodenitis: Inflammation of the bulb due to acid exposure, infections, or autoimmune conditions
Obstruction: Conditions such as duodenal web or annular pancreas may obstruct the bulb and cause vomiting or gastric outlet obstruction
Imaging: Readily evaluated with upper GI series (barium study) or esophagogastroduodenoscopy (EGD); ulcers appear as crater-like defects in the bulb
Perforation: Anterior duodenal ulcers may perforate into the peritoneal cavity, leading to peritonitis; posterior ulcers may erode into the gastroduodenal artery and cause massive hemorrhage
Understanding the anatomy and function of the duodenal bulb is essential for the diagnosis and management of upper gastrointestinal disorders, particularly in cases of peptic ulcer disease and related complications.
Did you know? The pancreas helps with digestion by releasing enzymes that break down fats, proteins, and carbohydrates.