Variations in the structure of the mucosa and papillae of the duodenum in adults

Abstract

Introduction. We know from the literature that the duodenum is the central organ of the biliopancreaticoduodenal system. The duodenal papillae and the longitudinal fold of the duodenal mucosa have many individual features, their knowledge is very important to understand the morphopathological changes of all processes that may occur at this level, but also to choose the right surgical tactics and subsequent prevention of postoperative complications. Aim of study. Using the macroscopic method of anatomical preparation, the mucosal folds, the size and shape of the duodenal papillae were studied on 20 organocomplexes in adults. Methods and materials. According to the literature, the dimensions of the duodenal parts vary: the superior part 4.5-5.8 cm, the descending part 9.4-10.2 cm, the horizontal part 10.1-12.0 cm, the ascending part 5.0- 6.2 cm. According to the authors Щербаков П., Лохматов М. М, the height of the major duodenal papilla is between the limits of 0.2-2.0 cm, from where in 80% of cases both ducts open (pancreatic and choledochus) and in others 20%, the pancreatic duct opens 2-4 cm higher. According to the authors В. В. Коваленко, С. Д. Denissov, the duodenal papilla is the most common place to undergo surgery, which is why it is necessary to know the individual features. Results. Using the preparation method, the morphological and individual characteristics of the duodenal mucosa and papillae were studied. According to our data, the superior duodenal part was 2.5 cm to 4.0 cm long, with an average of 3.4 cm ± 0.38 cm; descending part - from 5.0 cm to 7.5 cm, with an average of 6 cm ± 0.82 cm; the horizontal part was 5.0 cm to 8.2 cm long, with an average of 6.7 cm ± 1 cm; the ascending part of the duodenum was 2.1 cm and 3.8 cm long, with an average of 3.1 cm ± 0.48 cm. Regarding the duodenal folds, in 53% of the pieces, the longitudinal fold was present, in others 21% both folds were present (longitudinal and circular), in 16% both folds were absent, and in others 11% were present only circular fold around the major duodenal papilla. Regarding the height of the major duodenal papilla, the minimum value was 0.1 cm, the maximum being 1.0 cm, with an average of 0.33 cm ± 0.2 cm. Conclusion. According to our data, the duodenal mucosa has many individual varieties, both in terms of portion size and in terms of the height of the major duodenal papilla, as well as the presence or absence of duodenal folds. This is important to consider to prevent complications during surgery on the organ.