The descending part is the second part of the duodenum, about 7-10 cm long, running down from L1 to L3 just to the right of the vertebral column. It curves around the head of the pancreas and lies in front of the right kidney's hilum, with the transverse colon crossing its front. The bile and pancreatic ducts open on its inner (posteromedial) wall at the major duodenal papilla, with the minor papilla a little higher.
| Location | Right of the L1-L3 vertebrae, curving around the pancreatic head, in front of the right kidney and renal vessels |
|---|---|
| Parts | |
| Nerve Supply | Vagus nerve; Coeliac and superior mesenteric plexuses |
| Blood Supply | Anterior and posterior superior pancreaticoduodenal arteries; Anterior and posterior inferior pancreaticoduodenal arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Receives bile and pancreatic juice, which mix with chyme to continue digestion.
The major papilla in this part is the target of endoscopic retrograde cholangiopancreatography (ERCP) using a side-viewing scope. Surgeons mobilise this part and the pancreatic head by the Kocher manoeuvre, cutting the peritoneum along its lateral edge. An annular pancreas, a ring of pancreatic tissue around this part, can obstruct it.
Cancer arising at or near the major papilla in the descending duodenum, typically presenting with painless obstructive jaundice.
Congenital ring of pancreatic tissue encircling the descending duodenum, which can cause obstruction in newborns or adults.
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