膨大部括約筋
WordNet
- a flask that has two handles; used by Romans for wines or oils
- the dilated portion of a canal or duct especially of the semicircular canals of the ear
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/23 00:27:37」(JST)
[Wiki en表示]
Not to be confused with the Duodenal cap also known as the duodenal ampulla, the first part of the duodenum.
| Ampulla of Vater |
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A diagram of the Biliary system. Note that the ampulla of Vater is behind the Major duodenal papilla.
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The Major duodenal papilla, seen on duodenoscopy at the time of ERCP. This is the protrusion of the ampulla of Vater into the duodenum.
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| Details |
| Latin |
Ampulla hepatopancreatica, ampulla Vaterii |
| Identifiers |
| Gray's |
p.1199 |
| MeSH |
A03.159.183.079.300.950 |
Dorlands
/Elsevier |
12127886 |
| TA |
A05.8.02.017 |
| FMA |
15076 |
| Anatomical terminology |
The ampulla of Vater, also known as the hepatopancreatic ampulla,or as Hepatopancreatic duct, is formed by the union of the pancreatic duct and the common bile duct. The ampulla is specifically located at the major duodenal papilla.
The ampulla of Vater is an important landmark, halfway along the second part of the duodenum that marks the anatomical transition from foregut to midgut, and hence the point where the celiac trunk stops supplying the gut and the superior mesenteric artery takes over.
Contents
- 1 Structure
- 2 Function
- 3 Clinical relevance
- 4 History
- 5 Additional images
- 6 References
Structure
1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6. Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla
9. Gallbladder, 10–11. Right and left lobes of liver. 12. Spleen.
13. Esophagus. 14. Stomach. Small intestine: 15. Duodenum, 16. Jejunum
17. Pancreas: 18: Accessory pancreatic duct, 19: Pancreatic duct.
20–21: Right and left kidneys (silhouette).
The anterior border of the liver is lifted upwards (brown arrow). Gallbladder with Longitudinal section, pancreas and duodenum with frontal one. Intrahepatic ducts and stomach in transparency.
Hepatopancreatic anatomy: The cystic duct leaves the gallbladder and joins with the common hepatic duct to form the common bile duct. This duct subsequently joins with the pancreatic duct; this junction is known as the ampulla of Vater. The pancreatic duct delivers substances such as sodium hydrogencarbonate and digestive enzymes to the duodenum. The bile from the gallbladder contains salts which emulsify large fat droplets into much smaller units. This provides a large surface area for the lipase enzymes to act on. The sodium hydrogencarbonate neutralises the acidic chyme, creating alkaline conditions for enzymes such as chymotrypsin and amylase to work best at these pH levels.
Function
Various smooth muscle sphincters regulate the flow of bile and pancreatic juice through the ampulla: the sphincter of the pancreatic duct, the sphincter of the bile duct, and the hepatopancreatic sphincter (Sphincter of Oddi).
The sphincter of Oddi controls the introduction of bile and pancreatic secretions into the duodenum, as well as preventing the entry of duodenal contents into the ampulla.
Clinical relevance
Pancreatitis can result from a failure of pancreatic secretions to drain properly. One possible cause of impaired drainage of pancreatic juice is blockage of the hepatopancreatic ampulla. A common culprit to cause blockage is a gallstone in the common bile duct.
History
The eponymical term "ampulla of Vater" is named after Abraham Vater (1684–1751), a German anatomist who first published a description of it in 1720.[1]
Additional images
References
- ^ synd/3095 at Who Named It?
- "Ampulla, hepatopancreatic." Stedman's Medical Dictionary, 27th ed. (2000). ISBN 0-683-40007-X
- Moore, Keith L. and Arthur F. Dalley. Clinically Oriented Anatomy, 4th ed. (1999). ISBN 0-683-06141-0
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Accessory digestive glands
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| Liver |
- Bare area of the liver
- Ligamentum venosum
- Porta hepatis
- Round ligament of liver
- Lobes
- Left
- Right (Caudate lobe
- Quadrate)
- Fibrous capsule of Glisson
- Perisinusoidal space
- Liver sinusoid
- Periportal space
- Portal triad
- Lobules of liver
- Microanatomy
- Hepatocyte
- Hepatic stellate cell
- Kupffer cell
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| Biliary tract |
| Bile ducts |
- Intrahepatic bile ducts
- Bile canaliculus
- Canals of Hering
- Interlobular bile ducts
- Left hepatic duct
- Right hepatic duct
- Common hepatic duct
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| Gallbladder |
- Cystic duct
- Common bile duct
- Hepatopancreatic ampulla
- Cells
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| Pancreas |
- Gross
- Tail
- Body
- Neck
- Head (Uncinate process)
- Ducts
- Microanatomy
- Islets of Langerhans
- Centroacinar cell
- stellate cell
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Index of digestion
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| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Congenital
- Neoplasms and cancer
- Inflammatory bowel disease
- Gluten sensitivity
- Other
- Symptoms and signs
- Blood tests
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| Treatment |
- Procedures
- Drugs
- anabolic steroids
- antacids
- diarrhoea and infection
- bile and liver
- functional gastrointestinal disorders
- laxatives
- peptic ulcer and reflux
- nausea and vomiting
- other
- Surgery
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UpToDate Contents
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English Journal
- Poorly cohesive adenocarcinoma of the ampulla of Vater: a case report.
- Yamauchi H1, Sakurai S2, Hagiwara K3, Yoshida T4, Tabe Y5, Fukasawa T6, Kiriyama S7, Fukuchi M8, Naitoh H9, Kuwano H10.
- Surgical case reports.Surg Case Rep.2016 Dec;2(1):15. doi: 10.1186/s40792-016-0142-9. Epub 2016 Feb 15.
- A 47-year-old Japanese male was submitted to pancreaticoduodenectomy for an ampullary cancer. Pathologically, the ampullary cancer was poorly cohesive adenocarcinoma without tubular structure. Moreover, locoregional lymph nodes were swollen with hypervascularity, plasmacytes infiltration, and hemorr
- PMID 26943691
- Primary squamous cell carcinoma of the ampulla of Vater: a case report.
- Balci B1, Calik B2, Karadeniz T3, Sahin H4, Ugurlu L5, Aydin C6.
- Surgical case reports.Surg Case Rep.2016 Dec;2(1):2. doi: 10.1186/s40792-016-0130-0. Epub 2016 Jan 8.
- BACKGROUND: Primary squamous cell carcinoma of the ampulla of Vater is a very rare type of tumor, and the prognosis is not well known mainly due to a limited number of cases reported. Here, we aimed to report a case with primary squamous cell carcinoma of the ampulla of Vater.CASE PRESENTATION: A 54
- PMID 26943678
- MEK inhibitor treatment is effective in a patient with metastatic carcinoma of the ampulla of Vater with BRAF and NRAS mutations shown by next-generation sequencing.
- Tahover E1, Bar Shalom R, Bogot N, Kelsen D, Gabizon A.
- Anti-cancer drugs.Anticancer Drugs.2016 Jul;27(6):569-72. doi: 10.1097/CAD.0000000000000355.
- Here, we present a case of an 84-year-old woman who developed obstructive jaundice and was diagnosed with nonoperable adenocarcinoma originating from the ampulla of Vater, a lethal disease with a median overall survival of less than a year. Her tumor was examined by next-generation sequencing, which
- PMID 27075779
Japanese Journal
- Digestive Tract of Ganges Dolphin, Platanista gangetica<SUP>*</SUP>:II. Small and Large Intestines
Related Links
- hepatopancreatic ampulla [-pan′krē·at′ik] Etymology: Gk, hēpar + pan, all, kreas, flesh the dilation formed by the junction of the pancreatic and bile ducts as they open into the lumen of the duodenum. Also called ampulla of the bile ...
- hepatopancreatic ampulla [-pan′krē·at′ik] Etymology: Gk, hēpar + pan, all, kreas, flesh the dilation formed by the junction of the pancreatic and bile ducts as they open into the lumen of the duodenum. Also called ampulla of the bile ...
★リンクテーブル★
[★]
- 英
- hepatopancreatic ampulla (Z)
- ラ
- musculus sphincter ampullae
[★]
胆膵管膨大部括約筋