Abstract
Background
Duodenojejunal junction (DJJ) pressure decreased on duodenal contraction and increased on jejunal contraction. These findings postulated potential existence of anatomical sphincter at DJJ.
Methods
DJJ was studied by direct dissection in 34 cadavers and histologically in 24. Transverse and longitudinal sections across DJJ were cut and stained.
Results
DJJ was narrower than duodenum or jejunum and had one or two grooves occupied by arterial branch derived from superior mesenteric artery and we call it “duodenojejunal junction artery”. DJJ was thicker on palpation than duodenum or jejunum. Its mucous membrane was crowded into “DJJ rosette”. DJJ length varied in adults from 0.75 to 0.9 cm. Microscopically, circular muscle layer was thickened at DJJ.
Conclusion
The thickened circular muscle, mucosal rosette and narrowing at DJJ point to possible existence of anatomical sphincter at DJJ. Together with presence of high-pressure zone at DJJ, these findings would support such postulation.
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References
Arbell D, Orkin B, Naveh Y, Gur I, Udassin R (2006) Duodenojejunal atresia with absent dorsal mesentery, choledochal cyst, and malrotation in a premature newborn. A case report. J Pediatr Surg 41:11–13
DiDio LJA, Anderson MC (1968) The ‘Sphincters’ of the digestive system. In: DiDio LJA, Anderson MC (eds), 1st edn. Williams & Wilkins, Baltimore
Meeussen C, Huyghe M, Deckers E (2006) Paraduodenal hernia evoking intermittent abdominal pain. Acta Chir Belg 106:211–214
Ochsner AJ (1906) Construction of the duodenum below the entrance of the common duct and its relation to disease. Ann Surg 43:80–88
Pumberger W, Birnbacher R, Pomberger G, Deutinger J (2002) Duodeno-jejunal atresia with volvulus, absent dorsal mesentery, and absent superior mesenteric artery: a hereditary compound structure in duodenal atresia? Am J Med Genet 109:52–55
Shafik A (2006) Demonstration of a physiologic sphincter at duodeno-jejunal junction. Front Biosci 11:2790–2794
Skandalakis JE (2004) Small intestine. In: Skandalakis JE (ed) Skandalakis surgical anatomy. The embryologic and anatomic basis of modern surgery. Pascalidis: Medical Publications, Athens, pp 791–839
Sugimoto T, Yamagiwa I, Obata K, Ouchi T, Takahashi R, Suzuki R, Shimazaki Y (2002) Choledochal cyst and duodenal atresia: a rare combination. Pediatr Surg Int 18:281–283
Tropskaya NS (2005) Role of serotonin in the recovery of electrical activity in the stomach and small intestine of rats during the early postsurgery period. Bull Exp Biol Med 140:502–505
Villemin F (1922) Recherche d’anatomie comparée sur le duodenum de l’homme et des mammifères. Sa signification morphologique et functionelle. Arch Morphol Genel Exp 3:1–42
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Margot Yehia assisted in preparing the manuscript.
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Shafik, A., Shafik, A.A., Wahdan, M. et al. Duodeno-jejunal junction: a histoanatomical study with the concept of the existence of an “anatomical” sphincter. Surg Radiol Anat 29, 661–665 (2007). https://doi.org/10.1007/s00276-007-0268-3
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DOI: https://doi.org/10.1007/s00276-007-0268-3