関: antrum、gastric antrum

WordNet

a natural cavity or hollow in a bone
relating to or near the pylorus

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骨の空洞,(特に)上あご骨の空洞

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/01 21:04:25」(JST)

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The pylorus (/paɪˈlɔərəs/ or /pᵻˈlɔərəs/), or pyloric part, connects the stomach to the duodenum. The pylorus is considered as having two parts, the pyloric antrum (opening to the body of the stomach) and the pyloric canal (opening to the duodenum). The pyloric canal ends as the pyloric orifice, which marks the junction between the stomach and the duodenum. The orifice is surrounded by a sphincter, a band of muscle, called the pyloric sphincter.

The word pylorus comes from the Greek πυλωρός, "gate guard".

Structure

Diagram from cancer.gov:
* 1. Body of stomach

2. Fundus
3. Anterior wall
4. Greater curvature
5. Lesser curvature
6. Cardia
9. Pyloric sphincter
10. Pyloric antrum
11. Pyloric canal
12. Angular notch
13. Gastric canal
14. Rugal folds

The pylorus is the furthest part of the stomach that connects to the duodenum. It is divided into two parts, the antrum, which connects to the body of the stomach, and the pyloric canal, which connects to the duodenum.^[1]

Antrum

The pyloric antrum is the initial portion of the pylorus. It is near the bottom of the stomach, proximal to the pyloric sphincter, which separates the stomach and the duodenum. It may temporarily become partially or completely shut off from the remainder of the stomach during digestion by peristaltic contraction of the prepyloric sphincter; it is demarcated, sometimes, from the pyloric canal by a slight groove.

Canal

The canal (Latin: canalis pyloricus) is the opening between the stomach and the duodenum.^[2]

Sphincter

The pyloric sphincter, or valve, is a strong ring of smooth muscle at the end of the pyloric canal which lets food pass from the stomach to the duodenum. It controls the outflow of gastric contents into the duodenum.^[3] It receives sympathetic innervation from the celiac ganglion.

Histology

Microscopic cross-section of the pylorus.

Under microscopy, the pylorus contains numerous glands, including gastric pits, which constitute about half the depth of the pyloric mucosa. They consist of two or three short closed tubes opening into a common duct or mouth. These tubes are wavy, and are about one-half the length of the duct. The duct is lined by columnar cells, continuous with the epithelium lining the surface of the mucous membrane of the stomach, the tubes by shorter and more cubical cell which are finely granular. The glands contain mucus cells and G cells that secrete gastrin.^{[citation needed]}

The pylorus also contains scattered parietal cells and neuroendocrine cells. These endocrine cells including G cells, which produce gastrin, which stimulates gastric acid production, and D cells, which release somatostatin.^[4] (responsible for shutting off acid secretion. There is a second hormone-sensitive population near the fundus.)

Function

The pylorus is one component of the gastrointestinal system. Food from the stomach as chyme, passes through the pylorus to the duodenum. The pylorus, through the pyloric sphincter, regulates entry of food from the stomach into the duodenum.

Clinical significance

In such conditions as stomach cancer, tumours may partly block the pyloric canal. A special tube can be implanted surgically to connect the stomach to the duodenum so as to facilitate the passage of food from one to the other. This tube is called a gastroduodenostomy.

Stenosis

Pyloric stenosis refers to a pylorus that is narrow. This is due to congenital hypertrophy of the pyloric sphincter. The lumen of the pylorus is narrower, and less food is able to pass through. This problem is often detected in the early weeks of life. When it is present, a newborn baby may projectile vomit after eating, but despite vomiting remain hungry. Pyloric stenosis may be managed by the insertion of a stent, or through surgical cutting of the pyloric sphincter, a pyloromyotomy.^[5]

Other

Pyloric tumors
- Pyloric gland adenoma

History

The word pylorus comes from Greek via Latin. The word pylorus in Greek means "gatekeeper", related to "gate" (Greek: pyle) and is thus linguistically related to the word "pylon".^[6]

Additional images

Stomach
Dissection showing the stomach and pylorus in a cadaver. The antrum of the pylorus is shown in green.

References

^ Drake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. p. 272. ISBN 978-0-8089-2306-0.
^ University of Illinois Medical Center:Health Library
^ Snell, Richard S. (2008). Clinical Anatomy by Regions. Lippincott Williams & Wilkins. p. 220. ISBN 978-0781764049.
^ Deakin, Barbara Young ... [et al.] ; drawings by Philip J. (2006). Wheater's functional histology : a text and colour atlas (5th ed.). [Edinburgh?]: Churchill Livingstone/Elsevier. p. 273. ISBN 978-0-443-068-508.
^ Clayden, Tom Lissauer, Graham (2007). Illustrated textbook of paediatrics (3rd ed.). Edinburgh ; New York: Mosby/Elsevier. pp. 207–208. ISBN 9780723433972.
^ Harper, Douglas. "Pylorus". Etymology Online. Retrieved 27 March 2014.

External links

"Pylorus", Stedman's Online Medical Dictionary at Lippincott Williams and Wilkins
Anatomy photo:37:06-0105 at the SUNY Downstate Medical Center - "Abdominal Cavity: The Stomach"
Anatomy photo:38:07-0102 at the SUNY Downstate Medical Center - "Stomach, Spleen and Liver: The Pylorus"
Anatomy image:8150 at the SUNY Downstate Medical Center

UpToDate Contents

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1. 胃排出遅延の原因 pathogenesis of delayed gastric emptying
2. 幼児の肥厚性幽門狭窄症 infantile hypertrophic pyloric stenosis
3. 早期胃癌：疫学、臨床症状、診断、および病期分類 early gastric cancer epidemiology clinical manifestations diagnosis and staging
4. BillrothII法再建後のERCP ercp after billroth ii reconstruction
5. 小児の腐食性食道損傷 caustic esophageal injury in children

English Journal

Ultrasound assessment of the gastric contents for the guidance of the anaesthetic strategy in infants with hypertrophic pyloric stenosis: a prospective cohort study.

Gagey AC1, de Queiroz Siqueira M1, Desgranges FP1, Combet S1, Naulin C2, Chassard D3, Bouvet L4.
British journal of anaesthesia.Br J Anaesth.2016 May;116(5):649-54. doi: 10.1093/bja/aew070.
BACKGROUND: Evacuation of gastric content through a nasogastric tube, followed by rapid sequence induction, is usually recommended in infants undergoing pyloromyotomy. However, rapid sequence induction may be challenging, and is therefore controversial. Some anaesthetists regularly perform classical
PMID 27106968

Magnetic-assisted capsule endoscopy in the upper GI tract by using a novel navigation system (with video).

Rahman I1, Pioche M2, Shim CS3, Lee SP3, Sung IK3, Saurin JC2, Patel P1.
Gastrointestinal endoscopy.Gastrointest Endosc.2016 May;83(5):889-895.e1. doi: 10.1016/j.gie.2015.09.015. Epub 2015 Sep 25.
BACKGROUND AND AIMS: Capsule endoscopy for visualization of the upper GI tract has thus far been experimental and potentially expensive. Our aim was to demonstrate the maneuverability and evaluate the ability to completely visualize and maintain views in the upper GI tract by using a simple magnetic
PMID 26405045

Efficacy of Two Radiologic-Assisted Prophylactic Gastropexy Techniques.

Balsa IM1, Culp WT1, Johnson EG1, Glaiberman CB2, Grimes M1, Mayhew PD1, Palm CA3.
Veterinary surgery : VS.Vet Surg.2016 May;45(4):464-70. doi: 10.1111/vsu.12457. Epub 2016 Mar 23.
OBJECTIVE: To describe the technique and clinical outcome of prophylactic percutaneous radiologic-assisted gastropexy (PRG) and radiologic-assisted incisional gastropexy (RIG) in client-owned dogs.STUDY DESIGN: Prospective, nonrandomized clinical trial.ANIMALS: Fourteen client-owned, large, and gian
PMID 27007302

Japanese Journal

Primary Gastric Tuberculosis Presenting as Non-Healing Ulcer and Mimicking Crohns Disease

Ishii Naoki,Furukawa Keiichi,Itoh Toshiyuki,Fujita Yoshiyuki
Internal Medicine 50(5), 439-442, 2011
… Esophagogastroduodenoscopy (EGD) revealed an erosion in the pyloric antrum and a longitudinal ulcer on the lesser curvature of the gastric body. …
NAID 130000649855

胃原発浸潤性微小乳頭癌の1例

岡田明子,新井利幸,佐伯悟三,岡田禎人,広松孝,雨宮剛,井村仁郎,横井俊平,崎田健一,早川清順
日本消化器外科学会雑誌 43(11), 1112-1116, 2010-11-01
症例は77歳の男性で,主訴は黒色便で,近医での上部消化管内視鏡検査で胃前庭部前壁に2型腫瘍を認め,生検にて胃癌と診断された.手術目的に当院を紹介受診し,幽門側胃切除,D2郭清,Billroth I法再建を施行した.病理組織学的に乳頭腺癌,pT2(pSS), pN0, M0, Stage IBの診断であったが,空隙に囲まれた異型性の強い微小乳頭状の癌胞巣を認める浸潤性微小乳頭癌(invasive m …
NAID 110007880744

Related Pictures

★リンクテーブル★

リンク元	「幽門洞」「幽門前庭部」「gastric antrum」
関連記事	「pyloric」「antrum」

「幽門洞」

Pylorus
	Inside of the stomach (pylorus labeled at center left)
Details
Identifiers
Latin	Pylorus
Dorlands; /Elsevier	v_02/12844554
TA	A05.5.01.014
FMA	14581
	Anatomical terminology [edit on Wikidata]