Journal of Morphological Sciences
http://www.jms.periodikos.com.br/article/587cb4c27f8c9d0d058b485d
Journal of Morphological Sciences
Original Article

Anatomical variation in the insertion of the major duodenal papilla

Franco, S. S. D. R.; Mendes, L. F. M.; Fortes, L. H. S.; Siqueira, S. L.; Souza, I. K. F.

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Abstract

Introduction: The major duodenal papilla is usually located about eight centimeters distant from the pyloric ostium, in the descending portion of the duodenum. However, it is known that the distance of the papilla insertion may vary, and the ducts may not unite or not form a papillary structure. We describe the ectopic major duodenal papilla in two corpses owned by the Human Anatomy Laboratory at the Federal University of Ouro Preto. Materials and methods: Two corpses that had suffered prior formalinfixation were dissected and after the visualization of the anomalous character of the structures the distance from the pylorus was measured in each of them. In one of the corpses the major duodenal papilla was 5.2 cm distant from the pyloric ostium, lying posteromedial at the beginning of the upper duodenal flexure, while in the other one it was 6.7 cm distant from the pyloric ostium, lying posteromedial at the end of the upper duodenal flexure, between the first and second duodenal portions. A literature review of prevalence and surgical importance of this variation was performed through PubMed database and in anatomy and surgery textbooks. Results and conclusion: Dowdy and Disibeyaz described this type of variation and found 4% and 0,43% in their study, respectively. These anatomic variation findings are mainly relevant in surgeries of the biliary tract and pancreatic ducts and of the duodenum. A procedure in this case could inadvertently injure retroduodenal structures related to the ectopic papilla, increasing the rates of unsuccessful procedures, morbidity and mortality.

Keywords

duodenal papilla, major; ampulla of vater; duodenum; hepatic duct, common; duct of wirsung
587cb4c27f8c9d0d058b485d jms Articles
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J. Morphol. Sci.

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