Normal Small Intestine

  • Ingo Steinbrück
  • Martin Keuchel
  • Friedrich Hagenmüller
  • Axel von Herbay


The small bowel is a tubular organ 3–4 m in length, which starts at the pylorus and terminates at the ileocecal valve [1]. In a recent study, the small bowel length measured from the ligament of Treitz to the ileocecal valve was 2.83–3.45 m [2]. It is usually subdivided into the duodenum, jejunum, and ileum. The most proximal portion is the C-shaped duodenum, approximately 25 cm long, which is almost a fixed retroperitoneal structure. Four subdivisions of the duodenum are recognized: the first or superior portion (bulb, D1); the second or descending portion, which includes the papilla of Vater (D2); the third or horizontal portion (D3); and the fourth or ascending portion (D4). At the duodenojejunal flexure (the so-called ligament of Treitz), which is left of the midline at the level of the second lumbar vertebra, the duodenum becomes continuous with the intra-abdominal small intestine. Just by convention, the jejunum comprises the upper two-fifths of the intraperitoneal small intestine, and the distal three-fifths are designated as the ileum. The multiple intra-abdominal coils are mobile; they are attached to the mesentery (Fig. 19.1). The diameter decreases from about 25 mm in the duodenum to 19 mm in the distal ileum [3].


Normal small intestine Normal small bowel Pylorus Duodenum Gastric heterotopia Brunner’s glands Jejunum Ileum Terminal ileum villi Lymph follicles Ligament of Treitz Kerckring’s folds Papilla Ileocecal valve 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Ingo Steinbrück
    • 1
  • Martin Keuchel
    • 2
  • Friedrich Hagenmüller
    • 1
  • Axel von Herbay
    • 3
  1. 1.1st Medical DepartmentAsklepios Klinik AltonaHamburgGermany
  2. 2.Department of Internal MedicineBethesda Krankenhaus BergedorfHamburgGermany
  3. 3.HansepathologieHamburgGermany

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