Gross morphology of major and minor duodenal papilla: a cadaveric study

Abstract

Background: Anatomical location of the duodenal papilla is of vital importance while performing retrograde cannulation of the ampulla, trans-duodenal exploration of the common bile duct or sphincterotomy. This study was carried out to review the gross morphology of major and minor duodenal papillae in South Indians. Material and methods: One hundred specimens of duodenum and pancreas enblock, procured from cadavers and autopsy cases from Thanjavur medical college, Thanjavur, were carefully studied and the data obtained was compared with similar reports available in the literature. Results: Major duodenal papilla was present in all the specimens and was located in the II part of the duodenum in 94 specimens, at the junction of I and II part of the duodenum in five specimens and at the junction of the II & III part in one specimen. Minor papilla was absent in nine specimens. Size of the major papilla and minor papilla were 7.6 ± 0.29 mm and 04 ± 0.52 mm respectively. The average distance between the pylorus and minor papilla was 6.2±1.24 cm and between the pylorus and major papilla was 8.2±1.27 cm. The average distance between the major and minor papilla was 1.97± 0.57 cm . Conclusion: The constant introduction of newer and modified techniques in the diagnosis and management of the diseases has increased the importance of normal and variant anatomy. The present study highlights the variations in the gross morphology of the major and minor duodenal papilla in South Indians.

Keywords

• ampulla of vater
• dimensions
• anatomical location
• pancreatitis
• orifice