Imaging Approach to the Duodenum

(Left) The duodenum is retroperitoneal, except for the bulb (1st portion)

. The 3rd portion of duodenum crosses in front of the aorta and behind the superior mesenteric vessels

.

(Right) The 2nd portion of duodenum is attached to the pancreatic head and lies in close proximity to the right renal hilum. The ampulla of Vater lies along the medial wall of the 2nd duodenum. The hepatoduodenal ligament attaches the duodenum to the porta hepatic and contains the bile duct, portal vein, and hepatic artery.

(Right) The 2nd portion of duodenum is attached to the pancreatic head and lies in close proximity to the right renal hilum. The ampulla of Vater lies along the medial wall of the 2nd duodenum. The hepatoduodenal ligament attaches the duodenum to the porta hepatic and contains the bile duct, portal vein, and hepatic artery.

(Left) Spot film from an upper GI series shows a typical diverticulum extending from the medial border of the 2nd portion of the duodenum.

(Left) Spot film from an upper GI series shows a typical diverticulum extending from the medial border of the 2nd portion of the duodenum.

(Right) Axial CT in the same patient shows an air-fluid level within the duodenal diverticulum . A completely fluid-filled diverticulum may mimic a cystic mass in the head of the pancreas.

(Right) Axial CT in the same patient shows an air-fluid level within the duodenal diverticulum . A completely fluid-filled diverticulum may mimic a cystic mass in the head of the pancreas.

(Left) Film from an upper GI series in a patient with SMA syndrome shows the straight line demarcation of the midline duodenum, with dilation of the upstream duodenal lumen . The remainder of the small bowel is normal.

(Left) Film from an upper GI series in a patient with SMA syndrome shows the straight line demarcation of the midline duodenum, with dilation of the upstream duodenal lumen . The remainder of the small bowel is normal.

(Right) Film from an upper GI series in a patient with scleroderma shows a “megaduodenum” . Dilation of the small bowel lumen and a “hidebound” appearance of the small bowel folds (thin and closely spaced) are typical features of this disease.

(Right) Film from an upper GI series in a patient with scleroderma shows a “megaduodenum” . Dilation of the small bowel lumen and a “hidebound” appearance of the small bowel folds (thin and closely spaced) are typical features of this disease.

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Tags: Diagnostic Imaging Gastrointestinal

Nov 16, 2016 | Posted by admin in GASTROINTESTINAL IMAGING | Comments Off

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