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Minor duodenal papilla

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The minor duodenal papilla is the opening of the accessory pancreatic duct into the descending second section of the duodenum.

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Structure

The minor duodenal papilla is contained within the second part of the duodenum. It is situated 2 cm proximal to the major duodenal papilla, and thus 5–8 cm from the opening of the pylorus. The gastroduodenal artery lies posterior.[1]

Variation

The minor duodenal papilla may or may not contain a functioning sphincter and patent duct. When present, the sphincter is known as the sphincter of Helly, and the duct as the accessory pancreatic duct of Santorini. In 10% of people, the minor duodenal papilla is the prime duct for drainage of the pancreas,[1] although in others it may not be present at all.[2]

Pain from the region will be referred to the epigastric region of the abdomen due to its associated dermatomes. [citation needed]

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Function

The duct is an embryological remnant, however in a small majority of people drains the pancreas.[1] It is present in several domestic animals (e.g., dogs, cats and horses), being the sole drain of the pancreas in pigs and cows through the ductus pancreaticus accessorius.[3]

Development

The minor duodenal papilla represents the remnants of the opening of the accessory pancreatic duct, which drains the dorsal pancreatic bud during foetal development.

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Clinical significance

When patent, the minor duodenal papilla may be associated with recurrent pancreatitis. This is particularly common in a subset of people, when the dorsal pancreatic bud fails to fuse with the ventral pancreatic bud, a condition called pancreatic divisum,[4] :893 or when patent and ligated.[1]

History

The other names of minor duodenal papilla is Santorini's minor caruncle.

See also

References

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