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Ampulla of Vater

Benign/non-neoplastic

Normal anatomy

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 27 November 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Ampulla means flask like dilatation (spreading or stretching) of a tubular structure
● May refer to Ampulla of Vater, or portion of fallopian tube, vas deferens, semicircular canal or colon
● Vater (“fah-ter”) is German anatomist Abraham Vater (1684-1751) who first described this structure
● Usually refers to confluence of distal common bile duct and main pancreatic duct in second portion of duodenum near pancreatic head, although in 42% of patients, ampulla is termination of common bile duct only as the pancreatic duct enters the duodenum separately next to ampulla; in these cases, ampulla may be difficult to locate or nonexistent
● Ampulla is 1.5 cm long or less, traverses duodenal wall, opens into the duodenal lumen through (major) duodenal papilla (papilla of Vater), a 0.5 cm in diameter mucosal elevation with mucosal reduplications (valves of Santorini) that probably prevent regurgitation
● Minor papilla, also called accessory pancreatic duct (APD) of Santorini, is 2 cm proximal and slightly anterior to major papilla
● APD is Patent in 50% cases, pancreatic tissue is noted in 80% of cases in minor papilla (Dig Surg 2010;27:137)
● Ampulla is surrounded by muscular fibers of sphincter of Oddi

Gross images
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Figure 1 a and b

Micro images
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Figure 1 and 2

Drawings
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Local anatomy (called common duct)


Papilla

Additional references
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● Dig Surg 2010;27:90

End of Ampulla of Vater > Benign/non-neoplastic > Normal anatomy

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