IMR Press / FBL / Volume 11 / Issue 3 / DOI: 10.2741/2009

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Demonstration of a physiologic sphincter at duodeno-jejunal junction
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1 Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt. shafik@ahmedshafik.com
Front. Biosci. (Landmark Ed) 2006, 11(3), 2790–2794; https://doi.org/10.2741/2009
Published: 1 September 2006
Abstract

Current evidence suggests that there are three sphincters that regulate the flow of chyme from stomach to the duodenum. We investigated the hypothesis whether a fourth 'physiologic sphincter' exists at the duodeno-jejunal junction. The pressure response of the jejunum, duodeno-jejunal junction and duodenum to individual balloon distension of the jejunum and duodenum was recorded in 28 healthy subjected before and after anesthesizing the jejunum, duodeno-jejunal junction and duodenum. The duodeno-jejunal junction length was measured by the station pull-through technique. Duodenal balloon distension with 2 and 4 ml of normal saline did not change the pressures in the duodenum, duodeno-jejunal junction or jejunum (p>0.05). Distension with 6 ml saline produced an increase of duodenum pressure (p<0.01), a decrease of duodeno-jejunal junction pressure (p<0.01), and no change in the pressure of the jejunum (p>0.05), the balloon was expelled to the jejunum. Eight, and 10 ml duodenum balloon distension produced pressure changes similar to those of the 6 ml distension (p>0.05). Jejunum balloon distension with 2 and 4 ml saline induced no jejunum, duodeno-jejunal junction or duodenum pressure changes (p>0.05). Six ml balloon distension effected increase of jejunum (p<0.01) and duodeno-jejunal junction (p<0.05) pressure, but no duodenum pressure changes (p>0.05). Jejunum balloon distension with volumes more than 6 ml produced pressure changes similar to the 6 ml distension. Distension of the anesthetized duodenum, duodeno-jejunal junction or jejunum did not change the duodeno-jejunal junction pressure. A high pressure zone of 1.6±0.04cm length was detected at the duodeno-jejunal junction. Together, the findings show that a high pressure zone exists at the duodeno-jejunal junction suggesting that this region might act as a physiological sphincter.

Keywords
Chyme
Physiologic Sphincter
Biliary
Bile
Pancreatic Secretions
Reflux
Duodenal Motility
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