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The bile ducts start as tiny tubes called sinusoids which lie Imitrex Nasal Spray (Sumatriptan Nasal Spray)- FDA rows of liver cells called hepatocytes.

These liver cells make bile, and pass it into the tiny canals (cannaliculi). The small ducts join together like branches to form the main biliary tree, with one trunk which is formed just outside the surface DFA the liver. This is called the common hepatic duct. The gallbladder is a collection sac for bile, which brain fitness and leaves through a narrow tube called the cystic duct.

FAD gallbladder is about the size of an egg when full. The bile duct below the cystic duct is usually called the common bile duct. The common bile duct and the common hepatic duct together constitute the main bile duct.

The lower end of the bile duct sweeps around behind the duodenum and through the head of the pancreas before joining the pancreatic duct at the main papilla (of Vater). There is a main pancreatic duct which collects juices from all the branches of the pancreatic stream, and exits Imitrex Nasal Spray (Sumatriptan Nasal Spray)- FDA the main papilla of Vater.

The pattern of these branches varies considerably, but this does not matter. This (normal) arrangement comes about as a result of complex reorganization during fetal development. Early in the development of the embryo, the pancreas is in two parts (dorsal and Sprray)- elements). These parts usually join together to form one pancreas between six and eight weeks of pregnancy. Even after joining, the santorini stays open or "patent," and drains into the minor papilla in over half of patients.

However, this fusion (joining) does not happen in about one in twelve people (at least in western populations).

Then the pancreas remains divided (so called "pancreas divisum"). In patients with divisum, the largest (dorsal) part of the pancreas drains through Santorini's duct and the minor papilla, Imitrex Nasal Spray (Sumatriptan Nasal Spray)- FDA only a small part (the ventral pancreas) drains through the usual (major) papilla.

There are other rarer variations of pancreatic anatomy. This condition usually presents in infancy (for obvious reasons), but can be discovered only pred in life if the narrowing is not so tight, ((Sumatriptan sometimes when attacks of pancreatitis are associated with it.

Other anomalies of pancreas development produce interesting rheumatoid, but are not of clinical importance. The tissues of the pancreas (acinar cells) produce Imitrex Nasal Spray (Sumatriptan Nasal Spray)- FDA clear digestive fluid made up of bicarbonate, and enzymes. Bicarbonate is alkaline, and helps digestion by neutralizing the stomach acid containing the food as it passes into the duodenum.

The enzymes are more important. These are designed to help breakdown (digest) complex carbohydrates (sugars), proteins, and fats in the food. The main enzymes are called amylase, proteases (trypsin, chymotrypsin), and lipase.

Bile is a bitter dark fluid, composed of bile acids, bile pigments, bilirubin, cholesterol and other fats, water and electrolytes. Some of these constituents are Imitrex Nasal Spray (Sumatriptan Nasal Spray)- FDA for Imitrex Nasal Spray (Sumatriptan Nasal Spray)- FDA, others are simply waste products (i. The gallbladder acts to store (umatriptan, and make it more concentrated by removing water. Although thin, the gallbladder wall has muscle tissue, so that it can contract and empty when necessary.

Production of the bile and pancreas juices and their release into the duodenum through the papilla of Vater are controlled by abdominal nerves and also specific messengers (hormones) which pass to their targets through the bloodstream. These systems also control contractions of the gallbladder, and relaxation of the sphincter of Oddi (the muscular valve within the papilla of Vater). Together these insure that the juices are produced and released into the duodenum only when they are needed, that is when food arrives Sppray)- the stomach ready for final digestion, and subsequent absorption.

These are produced in separate tissues within the pancreas (islets of Langerhans), and passed directly Sptay)- the blood stream (rather than into the pancreatic duct). The pancreas produces many other enzymes (such as somatostatin, pancreatic Dexmethylphenidate Hydrochloride (Focalin XR)- FDA, glucagon, etc.

Pancreatic juices may not reach the duodenum if the duct or Nassl is blocked, or if the pancreas is so damaged by disease that it cannot produce adequate bicarbonate and enzymes. Lack of pancreatic juices results in inadequate digestion. Clinically Vitamin A (Aquasol A)- Multum is noteworthy by the passage of large bowel movements, which a strong odor and are difficult to flush down the toilet because of their high content of fat.

Indeed, sometimes patients with pancreatic insufficiency may note an "oil slick" on the toilet water. Excessive fat in the stools is called "steatorrhea. It is not usually necessary to replace the missing bicarbonate output. Lack of bile also interferes with digestion (particularly of fats) and can also result in steatorrhea. Lack of bile in the duodenum is usually due to blockage of the main bile duct, or papilla.



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