Small Bowel Resection

CHAPTER 11 Small Bowel Resection


The small intestine, the portion of the gastrointestinal (GI) tract located between the stomach and the ileocecal valve, is composed of three sections: the duodenum, jejunum, and ileum. The partially retroperitoneal duodenum is approximately 20 cm long and ends at the ligament of Treitz, a band of muscle that extends from the right crus of the diaphragm. Beyond the ligament of Treitz are the jejunum and ileum, which are attached to the retroperitoneum by a mesentery oriented obliquely from left to right and terminating at the cecum.

Digestion and absorption are the primary roles of the small intestine. Exocrine secretions from the liver and pancreas are delivered to the duodenum via the ampulla of Vater, and nutrients are absorbed through the small bowel mucosa. The small bowel is also the largest endocrine organ in the body and secretes numerous hormones that regulate both GI motility and pancreatic and gallbladder exocrine function. Finally, the small bowel protects the body from pathogens in the GI tract through a variety of mechanisms, including the secretion of mucin, peristalsis, and antigen sampling in lymphoid tissues (e.g., Peyer’s patches).

A wide range of disease processes affect the small bowel, including embryologic defects (e.g., malrotation and intestinal atresia), inflammatory diseases (e.g., Crohn’s disease), vascular diseases (e.g., mesenteric ischemia), and neoplasia. The surgical management of such processes may require the resection of small bowel, the topic of this chapter.


I. Small Bowel Obstruction

May 26, 2018 | Posted by in GENERAL SURGERY | Comments Off on Small Bowel Resection

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