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JUNCTION choledocho ulcer

the sphincter of Oddi

The choledocho-duodenal junction is always on the inner edge of the duodenum, but to varying degrees.

Classically bile duct after crossing obliquely the duodenal wall, ending in the middle of the second duodenum, in the back of the posterior and internal surfaces, 3 or 4 cm from the pylorus at the large caruncle .

The anastomosis of the bile duct into the duodenum is common with the termination of the MPD and they lead together in a small cavity, the ampulla, which opens into the large caruncle. In fact, the light bulb, very variable in size, is not constant.

The pancreatic duct can jump higher or lower in the terminal segment of the bile duct, although no mention of Vater. Finally, the two channels can be thrown separately into the duodenum, close to one another.

A lack of pancreatic duct was sometimes observed, the pancreatic secretion is then fully discharged by the duct of Santorini.

The exit of the bile duct and pancreatic duct is provided with a sphincter: the sphincter of Oddi, which normally opposes reflux of duodenal contents in hepato-pancreatic channel.

The projection of the sphincter duodénum forme la papille duodénale, recouverte d’un capuchon muqueux, comparé à un «phimosis» muqueux. L’orifice papillaire lui-même est très petit, le plus souvent de la dimension d’une tête d’épingle. Sur le vivant, il est difficile à voir du fait de l’importance et de la mobilité des villosités de la muqueuse duodénale.