Question that I don’t have the answer

[southernlady]

On the diagram of the DS, it shows the bilopancreatic limb up next to the liver, but is it attached to anything there? Or just hanging loose? If loose, what keeps it from wandering away?

 

[Larra]

The first portion of the BP limb, i.e. most of the duodenum, has attachments that are left in place when the duodenum is divided. It won't go anywhere.

 

[southernlady]

The first portion of the BP limb, i.e. most of the duodenum, has attachments that are left in place when the duodenum is divided. It won't go anywhere.

Thank you. I knew there had to be an answer. I just didn’t know what it was.

 

[Munchkin]

Mine has a titanium ring in it so it can be found if necessary. Don’t know if that is a common practice.

 

[Georgepds]

The first portion of the BP limb, i.e. most of the duodenum, has attachments that are left in place when the duodenum is divided. It won't go anywhere.

I know the small intestine is attached to the abdominal wall by the mesentary.... but when I looked it up, all healthline mentioned was the illeum and jejunum, not the duodenum.

Does the mesentary attach the duodenum, or is there another structure?

Mesentery: Definition, Picture, Anatomy, and Function

The mesentery is a newly classified organ in your abdomen. Learn more about what it does here.

www.healthline.com

When I dug deeper, I found the mesentary is connected to the duodenum , and the health line author just neglected to say it

http://www.thelancet.com/pdfs/journals/langas/PIIS2468-1253(16)30026-7.pdf

"The mesentery associated with the small intestine and colon is now regarded as contiguous (f i gure 1).2 It emerges from the superior mesenteric root region and fans out to span the intestine from duodenum to rectum;"

 

[Larra]

Yes, the mesentery is attached to all of the small intestine, including the duodenum. But no, the mesentery is not attached to the abdominal wall, unless by adhesions from, for example, abdominal surgery.

 

[Georgepds]

Yes, the mesentery is attached to all of the small intestine, including the duodenum. But no, the mesentery is not attached to the abdominal wall, unless by adhesions from, for example, abdominal surgery.

Good catch.... it emerges from the back of the abdominal cavity...though I don't know the name or shape of the structure it adheres to... though in source 2 it is identified as the posterior abdominal wall... or more precisely the " mesenteric root region"

Though they do use the term abdominal wall often

"Mesenteric contiguity was first demonstrated in an observational cohort study of patients undergoing total mesocolic excision,19 in which the entire mesocolon is detached from the posterior abdominal wall."

"In 1879, Toldt identified a mesentery associated with the ascending and descending colon and showed that, although these structures were flattened against the posterior abdominal wall"

I believe the point you are making is it does not attach to the anterior abdominal muscles/ peritoneum, loosely called the abdominal wall...

But I could be wrong...

 

[Georgepds]

Reading a bit deeper, most texts note he mesentery starts at the "duodenojejunal flexure".... as near as I can make out, this point is after the duodenum


Maybe the end off the duodenum does just remain unattached,post DS, relying on its connections to the jejunum ( with its mesentery) and pancreas ( also attached ) to keep it in position

Pre DS, of course it is connected at its' top to the stomach..


We could use a surgeon here

 

[Larra]

You're right. The term "abdominal wall" is almost always used to refer to the anterior abdominal wall, so technically the mesentery IS attached, but to the posterior abdominal wall only.
The duodenum has attachments to other structures in its vicinity as well as, of course, to the stomach and, at its other end, to the jejunum. It won't wander.