Major duodenal papilla

The major duodenal papilla (papilla of Vater) is a rounded projection in the duodenum into which the common bile duct and pancreatic duct drain. The major duodenal papilla is, in most people, the primary mechanism for the secretion of bile and other enzymes that facilitate digestion. The major duodenal papilla is situated in the second part of the duodenum, 7–10 cm from the pylorus, at the level of the second or third lumbar vertebrae. It is surrounded by the sphincter of Oddi, a circular muscle, and receives a mixture of pancreatic enzymes and bile from the Ampulla of Vater, which drains both the pancreatic duct and biliary system. The junction between the foregut and midgut occurs directly below the major duodenal papilla. The major duodenal papilla projects less than a centimetre into the lumen of the duodenum. It appears rounded and is often covered by a fold on the uppermost side of the papilla; that is, the side which receives contents from the stomach. The major duodenal papilla is seen from the duodenum as lying within a mucosal fold. The minor duodenal papilla is situated 2 cm proximal. The major duodenal papilla is occasionally found in the junction between the descending and horizontal parts of the duodenum, or in the horizontal part of the duodenum; a case study of 1000 people demonstrated this in 12 and 8% respectively. in the third part of the duodenum, the level of the vertebrae may be L2-3, and in about 10% of people, it may not receive bile. Additionally, in a small number of people, the primary papilla for draining the pancreas may in fact be the accessory pancreatic duct. Pancreatic enzymes and bile drain into the duodenum from both the pancreatic duct and biliary system. This facilitates the digestion of food; particularly proteins (pancreatic enzymes), and fat-soluble vitamins (bile). The minor papilla drains the duct of Santorini, superior in position to the major papilla.

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Major duodenal papilla

Ampulla of Vater

The ampulla of Vater, hepatopancreatic ampulla or hepatopancreatic duct is the common duct that is usually formed by a union of the common bile duct and the pancreatic duct within the wall of the duodenum. This common duct usually features a dilation ("ampulla"). The common duct then opens medially into the descending part of the duodenum at the major duodenal papilla. The common duct usually measures 2-10mm in length. The ampulla of Vater is an important landmark halfway along the second part of the duodenum marking the transition from foregut to midgut.

Common bile duct

The bile duct (formerly known as the common bile duct) is a part of the biliary tract. It is formed by the union of the common hepatic duct and cystic duct. It ends by uniting with the pancreatic duct to form the hepatopancreatic ampulla. It possesses its own sphincter to enable regulation of bile flow. The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter. Its proximal supraduodenal part is situated within the free edge of the lesser omentum.

Explores the anatomy and vascularization of the pancreas and duodenum.

Explores the anatomy of human systems and the structure of the colon.