Ampulla of Vater
{{Short description|Organ duct}}
{{distinguish|text=the Duodenal cap also known as the duodenal ampulla, the first part of the duodenum}}
{{use mdy dates|date=September 2021}}
{{Use American English|date = February 2019}}
{{Infobox anatomy
| Name = Ampulla of Vater
| Latin = ampulla hepatopancreatica, ampulla Vaterii
| Image = Biliary system new.svg
| Caption = A diagram of the biliary system. Note that the ampulla of Vater is behind the major duodenal papilla.
| Width = 200px
| Image2 = Ampulla endo.jpg
| Caption2 = The major duodenal papilla, seen on duodenoscopy at the time of ERCP. This is the protrusion of the ampulla of Vater into the duodenum.
| Precursor =
| System =
| Artery =
| Vein =
| Nerve =
| Lymph =
}}
The ampulla of Vater, hepatopancreatic ampulla or hepatopancreatic duct is the common duct that is usually formed by a union of the common bile duct and the pancreatic duct within the wall of the duodenum. This common duct usually features a dilation ("ampulla"). The common duct then opens medially into the descending part of the duodenum at the major duodenal papilla. The common duct usually measures 2-10mm in length.{{Cite book |last=Standring |first=Susan |url=https://www.worldcat.org/oclc/1201341621 |title=Gray's Anatomy: The Anatomical Basis of Clinical Practice |year=2020 |isbn=978-0-7020-7707-4 |edition=42nd |location=New York |pages=1219 |oclc=1201341621}}
The ampulla of Vater is an important landmark halfway along the second part of the duodenum marking the transition from foregut to midgut.{{Citation needed|date=July 2023}}
Structure
{{Bile ducts and pancreas}}
= Sphincters =
Various smooth muscle sphincters regulate the flow of bile and pancreatic juice through the ampulla: the sphincter of the pancreatic duct, the sphincter of the bile duct, and the sphincter of Oddi.{{cite journal|url=http://www.thieme-connect.de/DOI/DOI?10.1055/s-2007-1012982|title=Papilla of Vater: Structure and Function|journal=Endoscopy|volume=21|issue=S 1|pages=324–329|access-date=27 March 2020|via=www.thieme-connect.de|doi=10.1055/s-2007-1012982|year=1989|last1=Allescher|first1=H. D.|pmid=2691236|s2cid=38457896 |archive-date=June 2, 2018|archive-url=https://web.archive.org/web/20180602053613/https://www.thieme-connect.de/DOI/DOI?10.1055%2Fs-2007-1012982|url-status=dead|url-access=subscription}}
= Variation =
Clinical significance
Thomas' sign is the production of silver stools and can be indicative of cancer of the Ampulla of Vater. The ampulla of Vater is the site of tumors, often with a threatening prognosis and difficult surgical treatment. The silver-colored stool is a combination of the white stool of obstructive jaundice combined with black stool of melena or bleeding. It was first described in the British Medical Journal by Dr. H. Ogilvie in 1955.{{cite journal | pmid = 13219383 | volume=1 | issue=4907 | title=Thomas's sign, or the silver stool in cancer of the ampulla of Vater | pmc=2060824 | year=1955 | journal=Br Med J | page=208 | last1 = Ogilvie | first1 = H | doi=10.1136/bmj.1.4907.208}}
Etymology
The eponymic term "ampulla of Vater" is named after Abraham Vater (1684–1751),{{cite journal | last1 = Lerch | first1 = MM | last2 = Domschke | first2 = W | year = 2000 | title = Abraham Vater of the ampulla (papilla) of Vater | url = https://www.gastrojournal.org/article/S0016-5085(00)70243-5/fulltext | journal = Gastroenterology | volume = 118 | issue = 2| page = 379 | pmid = 10691372 | doi = 10.1016/s0016-5085(00)70243-5 | doi-access = free }} a German anatomist who first published a description of it in 1723.Vater A. Dissertation in auguralis medica, poes diss. Qua Scirris viscerum dissert, C.S. Ezlerus. Vol 70. 1723.
Additional images
File:Gray1100.png|The pancreatic duct.
File:Ultrasound Scan ND 090551 0930550 cr.png|Carcinoma of Ampulla
References
{{Reflist|2}}
- "Ampulla, hepatopancreatic." Stedman's Medical Dictionary, 27th ed. (2000). {{ISBN|0-683-40007-X}}
- Moore, Keith L. and Arthur F. Dalley. Clinically Oriented Anatomy, 4th ed. (1999). {{ISBN|0-683-06141-0}}
{{Accessory digestive glands}}
{{Portal bar|Biology|Medicine}}
{{Authority control}}