Duodenum

The duodenum develops from endoderm of the caudal portion of the foregut and the cranial portion of the midgut. It is roughly 26 cm length, extending from the pylorus to the ligament of Treitz. Brunner glands secrete a bicarbonate-rich mucus that is protective to the duodenal mucosa and provides an alkaline environment for digestive enzymes to activate. Duodenal ulcers, often caused by Helicobacter pylori, can cause epigastric pain. UGI and EGD studies can show ulcers or masses in the duodenum. Severe bleeding, perforation, and obstruction caused by duodenal ulcers are managed surgically. Complications of duodenal surgery may include bleeding, anastomotic leak or stricture, bile duct injury, pancreatitis or leak, reflux esophagitis, or dumping syndrome.