What is the duodenum?
The duodenum is the beginning of the small intestine via the stomach and close door (the pylorus) to the stomach. The remainder of the small intestine is formed by the jejunum (jejunum) and the ileum (ileum).
The duodenum is covered with single layer columnar epithelium with microvilli. It also contains mucus-producing goblet cells.
Etymology
The duodenum owes its name to its length of 20 to 25 centimeters, an equivalent of 12-inch widths, a measure used in the surgery.
Duodenum function
An important function of the duodenum is the neutralization of the pH. The chyme, the food slurry originating from the stomach, is very acidic, and may damage the rest of the gastro-intestinal tract. The pancreas (pancreas) produces hydrogen carbonate, a base which brings up the pH again. In addition, the pancreas produces too digestive enzymes, such as trypsin, lipase and amylase, which continue digestion. Also is added to the bile in the duodenum to the chyme, derived from the liver and gall bladder. The duodenum is beside pH-neutralization therefore also responsible for a part of the digestion.
Surrounding structures
At the level of the duodenal papilla (papilla of Vater), the bile ducts mouths (common bile duct) and the duct of the pancreas (pancreatic ducts) into the intestine.
At the level of the papilla of Santorini opens a second discharge passage of the pancreas (pancreatic duct accessorius) out in the intestine.
The duodenum is rotated around the head of the pancreas. A large part of the duodenum is secondary retroperitoneal that is to say that it is through fusion of a portion of the peritoneum peritoneum come to lie behind this.
Diseases
Duodenal
In the duodenum ulcers may occur, which are caused by gastric acid, and are often associated with the bacterium Helicobacter pylori and the use of NSAIDs. These sores can be identified through the gastroscopy, a check examination of the esophagus, stomach and duodenum. If during the investigation there is a bleeding than can be injected adrenaline, causing the blood vessels in the area to constrict. Often there biopsies taken during endoscopy, in which the pathologist can detect the bacteria. There will then be a so-called eradicatiekuur take place so that the bacterium is turned off. This eradicatiekuur consists of two antibiotics and an acid inhibitor. In rare instances ulcers are caused by an overproduction of gastric acid, by the syndrome of Zollinger-Ellison syndrome.
Celiac disease
In celiac disease, pathological changes occur in the small intestine, so that the original structure of crypts and microvilli changes. Gluten, the protein fraction of wheat, barley and rye flour, causes celiac disease. Patients who have celiac disease, often a result have deficiencies of essential nutrients such as folic acid or calcium. Patients have abdominal pain and diarrhea. Additionally occurs in children growth delay. The diagnosis is made by taking a biopsy during an endoscopy. Patients should adhere to a strict gluten-free diet.
Keeps you adhere to this diet, one can reasonably free of symptoms throughout life.
Carcinomas
Thin-intestinal cancer, i.e., cancer that originates in the small intestine, is extremely rare. However, different types of cancer metastasize to the small intestine, is a well known breast cancer (in particular lobular breast cancer).