Pyloric Cecum
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The pylorus ( or ), or pyloric part, connects the stomach to the
duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
. The pylorus is considered as having two parts, the ''pyloric antrum'' (opening to the body of the stomach) and the ''pyloric canal'' (opening to the duodenum). The ''pyloric canal'' ends as the ''pyloric orifice'', which marks the junction between the stomach and the duodenum. The orifice is surrounded by a sphincter, a band of muscle, called the ''pyloric sphincter''. The word ''pylorus'' comes from Greek πυλωρός, via Latin. The word ''pylorus'' in Greek means "gatekeeper", related to "gate" ( el, pyle) and is thus linguistically related to the word " pylon".


Structure

The pylorus is the furthest part of the stomach that connects to the
duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
. It is divided into two parts, the ''antrum'', which connects to the body of the stomach, and the ''pyloric canal'', which connects to the duodenum.


Antrum

The ''pyloric antrum'' is the initial portion of the pylorus. It is near the bottom of the stomach, proximal to the pyloric sphincter, which separates the stomach and the duodenum. It may temporarily become partially or completely shut off from the remainder of the stomach during digestion by
peristaltic Peristalsis ( , ) is a radially symmetrical contraction and relaxation of muscles that propagate in a wave down a tube, in an anterograde direction. Peristalsis is progression of coordinated contraction of involuntary circular muscles, which ...
contraction of the prepyloric sphincter; it is
demarcated {{Refimprove, date=January 2008 A political demarcation line is a geopolitical border, often agreed upon as part of an armistice or ceasefire. Africa * Moroccan Wall, delimiting the Moroccan-controlled part of Western Sahara from the Sahrawi- ...
, sometimes, from the pyloric canal by a slight groove.


Canal

The ''canal'' ( la, canalis pyloricus) is the opening between the stomach and the duodenum. The wall thickness of the pyloric canal is up to 3 millimeters (mm) in infants younger than 30 days, and up to 8 mm in adults.


Sphincter

The ''pyloric sphincter'', or valve, is a strong ring of smooth muscle at the end of the pyloric canal which lets food pass from the stomach to the duodenum. It controls the outflow of gastric contents into the duodenum. It receives sympathetic innervation from the
celiac ganglion The celiac ganglia or coeliac ganglia are two large irregularly shaped masses of nerve tissue in the upper abdomen. Part of the sympathetic subdivision of the autonomic nervous system (ANS), the two celiac ganglia are the largest ganglia in ...
.


Histology

Under
microscopy Microscopy is the technical field of using microscopes to view objects and areas of objects that cannot be seen with the naked eye (objects that are not within the resolution range of the normal eye). There are three well-known branches of micr ...
, the pylorus contains numerous
gland In animals, a gland is a group of cells in an animal's body that synthesizes substances (such as hormones) for release into the bloodstream (endocrine gland) or into cavities inside the body or its outer surface (exocrine gland). Structure De ...
s, including gastric pits, which constitute about half the depth of the pyloric
mucosa A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...
. They consist of two or three short closed tubes opening into a common duct or mouth. These tubes are wavy, and are about one-half the length of the duct. The duct is lined by columnar cells, continuous with the epithelium lining the surface of the mucous membrane of the stomach, the tubes by shorter and more cubical cell which are finely granular. The glands contain mucus cells and G cells that secrete
gastrin Gastrin is a peptide hormone that stimulates secretion of gastric acid (HCl) by the parietal cells of the stomach and aids in gastric motility. It is released by G cells in the pyloric antrum of the stomach, duodenum, and the pancreas. Gastrin ...
. The pylorus also contains scattered parietal cells and neuroendocrine cells. These
endocrine The endocrine system is a messenger system comprising feedback loops of the hormones released by internal glands of an organism directly into the circulatory system, regulating distant target organs. In vertebrates, the hypothalamus is the neu ...
cells including D cells, which release
somatostatin Somatostatin, also known as growth hormone-inhibiting hormone (GHIH) or by several other names, is a peptide hormone that regulates the endocrine system and affects neurotransmission and cell proliferation via interaction with G protein-couple ...
, responsible for shutting off acid secretion. (There is a second hormone-sensitive population near the
fundus ''Fundus'' (Latin for "bottom") is an anatomical term referring to that part of a concavity in any organ, which is at the far end from its opening. It may refer to: Anatomy * Fundus (brain), the deepest part of any sulcus of the cerebral cortex * ...
.) Unstriated muscles, which are entirely involuntary, are located at the pylorus.


Function

The pylorus is one component of the gastrointestinal system. Food from the stomach, as
chyme Chyme or chymus (; from Greek χυμός ''khymos'', "juice") is the semi-fluid mass of partly digested food that is expelled by a person's stomach, through the pyloric valve, into the duodenumduodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
. The pylorus, through the pyloric sphincter, regulates entry of food from the stomach into the duodenum.


Clinical significance

In such conditions as
stomach cancer Stomach cancer, also known as gastric cancer, is a cancer that develops from the lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes, including gastric adenocarcinomas. Lymph ...
, tumours may partly block the pyloric canal. A special tube can be implanted surgically to connect the stomach to the duodenum so as to facilitate the passage of food from one to the other. The surgery to place this tube is called a gastroduodenostomy.


Stenosis

Pyloric stenosis refers to a pylorus that is narrow. This is due to congenital hypertrophy of the pyloric sphincter. The lumen of the pylorus is narrower, and less food is able to pass through. This problem is often detected in the early weeks of life. When it is present, a newborn baby may projectile vomit after eating, but despite vomiting remain hungry. Pyloric stenosis may be managed by the insertion of a stent, or through surgical cutting of the pyloric sphincter, a ''pyloromyotomy''.


Other

*Pyloric tumors **Pyloric gland adenoma


Additional images

Image:Stomach2.gif, Stomach File:Stomach dissection highlighting pyloric antrum.jpg,
Dissection Dissection (from Latin ' "to cut to pieces"; also called anatomization) is the dismembering of the body of a deceased animal or plant to study its anatomical structure. Autopsy is used in pathology and forensic medicine to determine the cause o ...
showing the stomach and pylorus in a
cadaver A cadaver or corpse is a dead human body that is used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Stud ...
. The antrum of the pylorus is shown in green.


See also

* Human gastrointestinal tract * Stomach *
Duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
* Digestion


References


External links

*
Pylorus
, Stedman's Online Medical Dictionary at Lippincott Williams and Wilkins * - "Abdominal Cavity: The Stomach" * - "Stomach, Spleen and Liver: The Pylorus" * {{Authority control Digestive system Stomach