The horizontal (third or inferior) part of the duodenum is about 6-8 cm long and crosses from right to left at the level of L3. It passes in front of the inferior vena cava and aorta and behind the superior mesenteric artery and vein. The root of the small bowel mesentery crosses its front.
| Location | Crosses the midline at L3, anterior to the inferior vena cava and aorta and posterior to the superior mesenteric vessels |
|---|---|
| Parts |
|
| Nerve Supply | Vagus nerve; Superior mesenteric plexus |
| Blood Supply | Inferior pancreaticoduodenal arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Carries chyme mixed with bile and pancreatic juice across the abdomen toward the jejunum while digestion continues.
Because it lies between the aorta and the superior mesenteric artery, it can be compressed if the angle between them narrows, for example after rapid weight loss (superior mesenteric artery syndrome). Being pressed against the vertebral column, it is vulnerable to crush injury in blunt abdominal trauma. After aortic aneurysm repair, the graft can rarely erode into this part, causing an aortoenteric fistula with major bleeding.
Compression of the horizontal duodenum between the superior mesenteric artery and aorta, causing postprandial pain, vomiting and weight loss.
Abnormal connection between the aorta or an aortic graft and the third or fourth part of the duodenum, presenting with a herald bleed then massive haemorrhage.
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