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    6 The Jejunum and The Ileum Diya

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    Esosa Odighizuwa
    The jejunum and ileum are parts of the small intestine located between the duodenum and colon. The jejunum is the proximal 2/5th section and the ileum is the distal 3/5th section. They are attached to the posterior abdominal wall by the mesentery. The jejunum has thicker walls, wider lumen, more prominent plicae circularis, and longer vasa recta compared to the ileum. Both sections drain into the superior mesenteric vein and lymphatics before joining the portal vein. Rarely, Meckel's diverticulum can form on the ileum.

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    6 The Jejunum and The Ileum Diya

    Uploaded by

    Esosa Odighizuwa
    22 views24 pages
    The jejunum and ileum are parts of the small intestine located between the duodenum and colon. The jejunum is the proximal 2/5th section and the ileum is the distal 3/5th section. They are attached to the posterior abdominal wall by the mesentery. The jejunum has thicker walls, wider lumen, more prominent plicae circularis, and longer vasa recta compared to the ileum. Both sections drain into the superior mesenteric vein and lymphatics before joining the portal vein. Rarely, Meckel's diverticulum can form on the ileum.

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    6 The jejunum and the Ileum diya

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    The jejunum and ileum are parts of the small intestine located between the duodenum and colon. The jejunum is the proximal 2/5th section and the ileum is the distal 3/5th section. They are attached to the posterior abdominal wall by the mesentery. The jejunum has thicker walls, wider lumen, more prominent plicae circularis, and longer vasa recta compared to the ileum. Both sections drain into the superior mesenteric vein and lymphatics before joining the portal vein. Rarely, Meckel's diverticulum can form on the ileum.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    22 views24 pages

    6 The Jejunum and The Ileum Diya

    Uploaded by

    Esosa Odighizuwa
    The jejunum and ileum are parts of the small intestine located between the duodenum and colon. The jejunum is the proximal 2/5th section and the ileum is the distal 3/5th section. They are attached to the posterior abdominal wall by the mesentery. The jejunum has thicker walls, wider lumen, more prominent plicae circularis, and longer vasa recta compared to the ileum. Both sections drain into the superior mesenteric vein and lymphatics before joining the portal vein. Rarely, Meckel's diverticulum can form on the ileum.

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    of 24

    The jejunum and the Ileum

    Prof. Oluwadiya KS
    www.oluwadiya.siteled.com
    Introduction
    Introduction
    • The small intestine (SI) comprises of the
    duodenum, jejunum and the ileum
    • The jejunum is the second part of the small
    intestine and it begins at the duodenojejunal
    flexure
    • It forms the proximal 2/5th of the intraperitoneal
    part of the SI before becoming the ileum
    • Both the jejunum and the ileum are entirely
    intraperitoneal
    • Together, both measures between 3 and 7 metres
    (About 60% of the GI)
    Mesentery
    • Fan shaped peritoneal fold
    • Attaches the jejunum & ileum to the posterior
    abdominal wall
    • It has a root which is about 15cm
    • The average breath (from attachment to
    intestinal wall is about 20cm
    • The root extends from the duodenojejunal
    junction on the left side of vertebra L2 to the
    ileocolic junction and the right sacroiliac joint
    directed to the right obliquely and inferiorly
    Mesenteric root: Relations
    The root of the mesentery crosses successively:
    • The ascending and horizontal parts of the
    duodenum
    • Abdominal aorta
    • IVC
    • Right ureter
    • Right psoas major
    • Right testicular or ovarian vessels.
    Mesenteric root
    Mesentery: Contents
    • Between the two layers of the mesentery are:
    • The superior mesenteric vessels
    • Lymph nodes
    • A variable amount of fat
    • Autonomic nerves to and from the small
    intestine.
    Ileocaecal Junction
    • This is the point where the ileum opens into the large
    intestine (Caecum)
    • The ileocecal fold which are two flaps projecting into
    the lumen of the large intestine surround the opening
    • Muscle fibres from the ileum continues into each flap,
    forming a sphincter.
    • Possible functions of the ileocecal fold are:
    a) The prevention of reflux from the cecum to the
    ileum
    b) Theregulation of the passage of contents from the
    ileum to the cecum
    Ileocaecal Junction
    Jejunum and ileum: Arterial supply
    • This is the Superior Mesenteric Artery.
    • It arises from the abdominal aorta at the level of
    the L1 vertebra, about 1 cm inferior to the celiac
    trunk
    • Second, unpaired branch of the abdominal aorta
    • It is crossed anteriorly by the splenic vein and the
    body of the pancreas, separated from the aorta by
    the left renal vein.
    • Courses parallel to aorta, then turns oblique
    toward right iliac fossa
    Superior Mesenteric Artery

    Superior mesenteric
    artery

    SMA gives rise to the inferior


    pancreaticoduodenal
    artery
    Jejunum and ileum: Arterial supply
    • The SMA runs between the layers of the
    mesentery, sending branches to the jejunum and
    ileum.
    • The arteries unite to form loops or arches, called
    arterial arcades, which give rise to straight
    arteries, called vasa recta.
    • The patterns of the arcades and vasa recta helps
    in differentiating between jejunum and ileum
    Superior Mesenteric Artery
    Distribution of the SMA

    i. Pancreas
    ii. Small intestines
    iii. Cecum
    iv. Appendix
    v. Ascending &
    transverse colon
    Branches of the SMA
    i. Inferior
    Pancreaticoduodenal
    Artery
    ii. Jejunal and Ileal
    branches
    iii. Ileocolic Artery
    iv. Right Colic Artery
    v. Middle Colic Artery
    Jejunum and ileum: Venous drainage

    • This is the superior mesenteric vein.


    • It drains the jejunum and ileum .
    • It lies anterior and to the right of the SMA in the
    root of the mesentery.
    • The SMV ends posterior to the neck of the
    pancreas, where it unites with the splenic vein to
    form the portal vein.
    Jejunum and ileum: Venous drainage
    Jejunum and ileum: Lymphatic
    drainage
    Successively, the lymphatics
    of the SI drains into:
    • Juxta-intestinal lymph
    nodes: located close to
    the intestinal wall.
    • Mesenteric lymph nodes:
    scattered among the
    arterial arcades.
    • Superior central nodes:
    located along the
    proximal part of the SMA.
    Jejunum and Ileum: Differences

    Feature Jejunum Ileum


    Wall Thicker Thinner
    Lumen Wider Narrower
    Fat Present only on mesentery Present on both mesentery
    and wall
    Plicae Circularis Prominent Less prominent
    Arterial arcades Single layer Several layers
    Vasa rectae Long (about 4vm) Short(1-2cm)
    Aggregate lymph nodes Sparse Frequent
    (Payer’s patches
    Differentiating between Jejunum & Ileum:
    Plicae Circularis
    Jejunum Ileum
    Differentiating between Jejunum & Ileum:
    Arterial arcades/Vasa recta
    Jejunum Ileum
    Differentiating between Jejunum & Ileum:
    Fats/peyer’s patches/circular folds
    Jejunum Ileum
    Meckel's diverticulum
    • Remnant of the proximal part of the yolk stalk
    (vitelline duct), which extends into the
    umbilical cord in the embryo and lies on the
    antimesenteric border of the ileum.
    • occurs in approximately 2% of the population
    • Can Cause diverticulitis which produces
    symptoms of abdominal pain, swelling,
    constipation etc in a small number of
    patients.
    Any Question?

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