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    Related Topics

    From Digestive System

    Lingual Frenulum
    Fold of mucous membrane anchoring the tongue to the floor of the mouth.
    Oral Cavity
    Entry point of the digestive system; includes teeth, tongue, and salivary openings.
    Cardia
    Upper opening of the stomach.
    Ileocecal Valve
    Controls flow from ileum to cecum.
    Uvula
    Dangling soft tissue at the back of the soft palate.
    Cystic Duct
    Connects gallbladder to common bile duct.
    Body of Pancreas
    Central elongated portion of pancreas.
    Hard Palate
    Bony anterior portion of the roof of the mouth.
    Internal Anal Sphincter
    Involuntary muscle around anal canal.
    Rugae of Stomach
    Internal folds allowing expansion of the stomach.
    Haustra
    Pouch-like segments of colon.
    Tail of Pancreas
    Tapered end of pancreas near spleen.
    Palatine Tonsils
    Lymphatic tissues on either side of the oropharynx.
    Lips
    Fleshy borders of the mouth that aid in speech and food intake.
    Gallbladder
    Stores and concentrates bile.
    Fundus
    Upper curved portion of the stomach.
    Right Lobe
    Larger functional lobe of the liver.
    Gingiva
    Gums; soft tissue covering the bones of the jaw.
    Epiploic Appendages
    Fat-filled pouches attached to colon.
    Parotid Glands
    Largest salivary glands located near the ear.
    Ligamentum Venosum
    Remnant of ductus venosus in liver.
    Tongue
    Muscular organ aiding in taste, speech, and food manipulation.
    Descending Colon
    Vertical segment of the colon on the left side.
    Cheeks
    Lateral walls of the oral cavity composed of muscle and fat.
    Teniae Coli
    Longitudinal muscle bands of colon.

    Major Duodenal Papilla

    Reviewed by our medical team

    Opening for bile and pancreatic ducts into duodenum.

    Overview

    The major duodenal papilla is a small, raised structure in the wall of the duodenum through which bile and pancreatic enzymes are released into the small intestine. It serves as the outlet for the common bile duct and the main pancreatic duct and plays a critical role in digestion by delivering digestive juices into the gastrointestinal tract. Its patency and regulation are essential for proper digestion and prevention of biliary or pancreatic disease.

    Location

    The major duodenal papilla is located in the second part of the duodenum

    • Is found on the posteromedial wall of the duodenum

    • Approximately 7–10 cm distal to the pylorus

    • Lies near the level of the L2 vertebra and is visible during endoscopy as a small mound or bulge

    It marks the junction between the foregut and midgut embryologically.

    Structure

    The major duodenal papilla consists of:

    • Mucosal elevation: A small, visible bulge covered by intestinal epithelium

    • Opening (orifice): Central slit or hole where the hepatopancreatic ampulla (ampulla of Vater) opens into the duodenum

    • Sphincter of Oddi: A complex of smooth muscle that surrounds the terminal portion of the bile and pancreatic ducts; it regulates flow and prevents reflux

    Sometimes, a second opening called the minor duodenal papilla exists proximally, draining the accessory pancreatic duct.

    Function

    The primary function of the major duodenal papilla is to:

    • Serve as the drainage site for the common bile duct and the main pancreatic duct

    • Deliver bile and pancreatic enzymes into the duodenum to assist in digestion

    • Act as a barrier: The sphincter of Oddi prevents backflow of duodenal contents into the ducts

    Physiological Role(s)

    The major duodenal papilla is involved in several key physiological processes:

    • Initiation of digestion: Receives bile (for fat emulsification) and pancreatic enzymes (for breakdown of proteins, carbohydrates, and fats)

    • pH neutralization: Bicarbonate-rich pancreatic secretions help neutralize acidic chyme entering from the stomach

    • Hormonal regulation: Its activity is controlled by digestive hormones like cholecystokinin (CCK) and secretin

    • Sphincter relaxation: The sphincter of Oddi relaxes during digestion to allow flow, and contracts during fasting to prevent reflux

    Clinical Significance

    The major duodenal papilla is a critical site in multiple clinical conditions and procedures:

    • Gallstones: Stones from the gallbladder may lodge at or near the papilla, causing obstructive jaundice or pancreatitis

    • Pancreatitis: Obstruction at the papilla can cause backflow of pancreatic enzymes, leading to inflammation and auto-digestion of the pancreas

    • Ampullary carcinoma: A rare cancer that originates in the ampulla of Vater, often causing painless jaundice, and detectable via endoscopy

    • Sphincter of Oddi dysfunction: A motility disorder causing biliary-type pain and abnormal drainage of bile/pancreatic fluid

    • Endoscopic retrograde cholangiopancreatography (ERCP): A diagnostic and therapeutic procedure where a scope is passed to the papilla to access the biliary and pancreatic ducts

    • Papillotomy (sphincterotomy): Endoscopic incision of the papilla is often performed to relieve obstruction or remove stones

    Any pathology involving the major duodenal papilla can significantly impact digestion and hepatopancreatic function. It is a key anatomical target in both gastroenterology and surgical procedures.

    Did you know? The stomach acid is strong enough to dissolve metal, but the stomach lining protects itself from being digested!