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General Surgery
Small Intestine
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
14 sections · 197 slides
Overview
- Scope of this topic
Anatomic and surgical history
- Reading the historical record
- Anatomic and Surgical History of the Small Intestine
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
- Anatomic and Surgical History of the Small Intestine (continued)
Embryogenesis
- Embryologic origin of the three parts
- Retroperitoneal position of the duodenum
- Elongation and herniation of the midgut
- Physiological herniation of the midgut
- Stages of midgut development
- Return of the intestines to the abdomen
- Adult position of the intestines
- Rotation and the duodenal-SMA relationship
- Rotation of the pancreas and duodenum
- Fascia of Treitz and the Kocher manoeuvre
- Recanalisation of the duodenal lumen
- Maturation of mucosa, muscle and nerve
- Incomplete intestinal rotation
Congenital anomalies
- Duodenal stenosis
- Types of intestinal atresia
- Classification of intestinal atresia
- Duodenal anomalies in the adult
- Morbidity and mortality in intestinal atresia
- Duodenal diverticula
- Jejunoileal atresia: features and repair
- Formation of dorsal enteric duplications
- Intestinal duplications
- Surgical options for intestinal duplication
- Management of intestinal duplications
- Origin of Meckel's diverticulum
Surgical anatomy of the duodenum
- First part of the duodenum
- Second part of the duodenum
- Third part of the duodenum
- Fourth part of the duodenum
- Relationships of the duodenum and pancreas
- The Vaterian system and the ampulla
- Mucosal landmarks of the major papilla
- The major duodenal papilla
- Duct relations at the duodenal papilla
- The four components of the sphincter of Boyden
- Sphincter of Boyden and the Oddi misnomer
- The minor duodenal papilla
- Arterial supply of the duodenum
- Major arterial supply to the duodenum
- Anterior arterial supply of duodenum and pancreas
- Posterior arterial supply of duodenum and pancreas
- Vessels of the anterior aspect of the duodenal bulb
- Vessels of the posterior aspect of the duodenal bulb
- Blood currents of the duodenal bulb
- Venous drainage of the duodenum
- Venous drainage of duodenum and pancreas
- Formation of the hepatic portal vein
- Lymphatic drainage of the duodenum
- Innervation of the duodenum
Surgical anatomy of the jejunum and ileum
- Functional share of the jejunoileum
- Peritoneal fossae and referred pain
- Measured length of the small intestine
- Residual bowel and outcome after resection
- Factors Influencing Decision to Restore Intestinal Continuity
- Resection margins in the jejunoileum
- Distinguishing jejunum from ileum
- Some Differences between Jejunum and Ileum
- Branching pattern of the superior mesenteric artery
- Arterial arcades of the jejunum and ileum
- Patterns of the vasa recta
- Absence of collateral circulation beyond the arcades
- Vascular cast of the jejunal wall
- Intramural vessels, veins and lymphatics
- Dimensions of the mesentery
- Breadth of the small bowel mesentery
- Mesenteric root and elongation for an ileal pouch
- Ileocaecal vascular anatomy for pouch construction
- Terminal loop after section
- Elongation by section of the ileocolic artery
- Elongation by section between vascular arches
- Anatomy of the ileocaecal valve
- Living and cadaveric appearance of the ileocaecal valve
- Terminal ileum and appendiceal abscess
Meckel's diverticulum
- Surgical anatomy of Meckel's diverticulum
- Location and frequency along the ileum
- Limits and mucosa of vitelline duct remnants
- Types of Meckel's diverticulum
- Incidence of Meckel's diverticulum
- Age and sex distribution of Meckel's diverticulum
- Pattern of Meckel's diverticulum disease
- Bleeding from ectopic gastric mucosa
- Obstruction and intussusception
- Inflammation, neoplasms and umbilical presentations
- Management of the incidental Meckel's diverticulum
Histology and physiology
- Layers of the duodenal wall
- Duodenal mucosal cells and Brunner's glands
- Gastroduodenal junction and duodenal fixation
- Variations of the suspensory ligament of Treitz
- Bare areas of the duodenum
- Duodenal control of gastric emptying
- Section through the wall of the small intestine
- Submucosa and the suture-holding layer
- Layers of the jejunal and ileal wall
- Absorption, turnover and the rarity of neoplasia
Neoplasms of the small intestine
- Overview of small bowel tumours
- Pathology of Primary Small Bowel Tumors by Cell of Origin
- Pathology of Primary Small Bowel Tumors by Cell of Origin (continued)
- Distribution of Malignant Tumors of the Small Bowel by Site in 27 Series
- Distribution of Benign Tumors of the Small Bowel by Site in 13 Series
- Distribution of leiomyomas along the small intestine
- Distribution of leiomyosarcomas along the small intestine
- Operating under diagnostic uncertainty
- Aggressive surgery in midgut carcinoid syndrome
- Treatment programme in midgut carcinoid syndrome
- Outcomes of 64 patients with midgut carcinoid syndrome
Surgical applications to the duodenum
- Operating on the first and second parts
- Operating on the third and fourth parts
- Bleeding duodenal ulcer
Vascular compression of the duodenum
- Anatomy of vascular compression
- Sagittal relations of the third part of the duodenum
- Anterior view of the duodenum and superior mesenteric artery
- Anatomic variations: level of duodenal crossing
- Anatomic variations: ligament of Treitz and SMA origin
- Aortomesenteric Angles
- Symptoms and treatment of vascular compression
- Effect of dividing the suspensory ligament
- Interpreting vascular compression clinically
- Exposures of the duodenum
Jejunum and ileum: operative problems
- Diagnostic approach to the jejunum and ileum
- Anatomy of intussusception
- Anatomy of an intestinal intussusception
- Causes of intussusception in children
- Location and extent of intussusception in children
- Identifiable causes of intussusception
- Predisposing Factors to the Development of Intussusception
- Predisposing Factors to the Development of Intussusception (continued)
- The two-thirds rule in adult intussusception
- Stages of intussusception
- Diagnosis, reduction and after-care
- Nature and rarity of mesenteric cysts
- Sites of omental and mesenteric cysts
- Distribution and types of mesenteric cysts
- Classification of mesenteric cysts
- Classification of mesenteric cysts (continued)
- Classification of mesenteric cysts (continued)
- Classification of mesenteric cysts (continued)
- Theories on the Etiology of Mesenteric Cysts
- Theories on the Etiology of Mesenteric Cysts (continued)
- Presentation and diagnosis of mesenteric cysts
- Operative treatment of mesenteric cysts
- Mesenteric ischaemia and venous thrombosis
- Non-pathologic reasons for intestinal resection
Anatomic complications of resection
- Summary of Anatomic Complications of Small Intestine Resections
- Vascular injury at intestinal resection
- Angle of transection for segmental resection
- Haematoma and ischaemia at the anastomosis
- Organ injury, leakage and adhesions
- Stoma placement in side-to-side anastomosis
- Tension, torsion and distal obstruction
- Complications Related to Needle Catheter Jejunostomy in 2022 Consecutive Applications
- Complications Related to Needle Catheter Jejunostomy in 2022 Consecutive Applications (continued)
Consolidation
- Embryology and fixation: the essentials
- Vascular principles to carry into theatre
- Operative rules for the small bowel
- Sources cited in the text
- Sources cited in the text (continued)
- Sources cited in the text (continued)
- Sources cited in the text (continued)
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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