“Head Over Heels” Position of Duodenum-A Unique Congenital AnomalyCorrespondence Address :
Dr. Satheesha B Nayak,
Professor, Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy for Higher Education,
Madhav Nagar, Manipal, Udupi-576104, Karnataka, India.
Knowledge of congenital anomalies of duodenum and biliary apparatus is useful in radiological diagnosis and surgical procedures of upper abdominal region. We present concurrent variations of duodenum, bile duct and coeliac trunk in this report. The first part of the duodenum descended downwards in front of the head of the pancreas. At the lower end of the head of the pancreas, it ascended upwards along the right border of the head of the pancreas until the first lumbar vertebra. At the level of first lumbar vertebra, it continued to the left as its third part. The third and fourth part passes behind the head, neck and the body of the pancreas (and also behind superior mesenteric vessels). On the left side of the second lumbar vertebra, the duodenum continued as jejunum at the duodenojejunal flexure. The common bile duct coursed down in front of the head of the pancreas, being surrounded by a few pancreatic acini in the lower part of its course. It terminated at the hepatopancreatic ampulla, which opened into the first part of the duodenum. The coeliac trunk passed through the body of the pancreas before it divide into its terminal branches.
Bile duct, Coeliac trunk, Intestine, Pancreas
Satheesha B Nayak, Sudarshan Surendran, Prakashchandra Shetty, Surekha D Shetty. “HEAD OVER HEELS” POSITION OF DUODENUM-A UNIQUE CONGENITAL ANOMALY. Journal of Clinical and Diagnostic Research [serial online] 2018 March [cited: 2019 Jan 19 ]; 12:AD01-AD02. Available from
Date of Submission: Nov 11, 2017
Date of Peer Review: Jan 24, 2018
Date of Acceptance: Jan 29, 2018
Date of Publishing: Mar 01, 2018
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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