 So this is going to be a demonstration of the diodenum and some related structures which are right next to it. We can see there's a stomach here which has been cut open. So let's start off from the pyloric sphincter here. This is the pyloric sphincter and we can see the pyloric sphincter is thick muscle. Immediately after the pyloric sphincter is this portion here which is relatively smooth free from any mucosal folds. This is the first part of the diodenum or the superior part of the diodenum which is at the level of L1 which has been opened out. Then we have this portion of the diodenum which is the descending portion of the diodenum which is from L1 to L3. Then we have this portion of the diodenum which is at the level of L3. This is the horizontal part of the diodenum. And finally we have the last part of the diodenum which goes from L3 to L2 and at the dj flexure, diodenal gizernal flexure, it from the retropatoneal it becomes the intrapatoneal gizernum and this is the cut portion of the gizernum. So this is the dj flexure. So these are the four parts of the diodenum. I would like you to notice this fibromuscular structure which is attached to the diodenal gizernal flexure. This is the fibromuscular structure I was referring to. This is referred to as the suspensory ligament of tribes. This holds up the dj flexure. It runs up, it goes behind the pancreas which we can see here. This is the pancreas and from under the pancreas it gets attached to the right cross of the diaphragm. The next thing I would draw your attention to are the mucosal folds inside the diodenum. The first into the first part of the diodenum is intrapatoneal. This is also referred to as the diodenal cap or the diodenal ampulla in radiology. And that is also the most common side of diodenal ulcer. Apart from the first part which I told you is relatively free from mucosal folds, we can see from the second part onwards the diodenal folds are transverse and they are going all the way to the third part and to the fourth part which we have cut it open here to show the fourth part of the diodenum here. We also notice that the diodenum is quite dilated and yet one more thing I will draw your attention to is where my finger is gone in. This is papilla of vetter which is very dilated in this particular patient. Normally it is not so big and here we can see my probe has gone into the head of the pancreas. And not only that, when I turn the probe up, we can see that it is coming to the common bile duct here. This is the common bile duct and we can see the common bile duct is coming from the port of Hepatis and it is entering through the head of the pancreas which we have split open and it is meeting with the main pancreatic duct and they are all opening here in the papilla of vetter in the main pancreatic duct. This is at the second part of the diodenum and this marks the junction between the mid gut and the fore gut. The next thing which I would like to draw your attention to is diodenal diverticulum. This is one huge diodenal diverticulum that this patient had and we can see my finger is inside the diodenum and it has gone into the diverticulum. This patient also had another diodenal diverticulum which we can see here. So this patient had multiple diodenal diverticulum and in this connection I would like to remind you that there is a syndrome called the lemon syndrome where a large diodenal diverticulum can compress the common bile duct and can produce obstructive jaundice. I don't know whether this patient had lemon syndrome or not but that is a clinical entity. So obviously this patient had quite a few abnormalities. That brings me to the arterial supply of the pancreas, head of pancreas and the diodenum. To preview to speed this is the celiac trunk. The celiac trunk is giving rise to the largest branch which is the spleenic artery. The second largest branch common hepatic artery. The third branch left gastric artery. So from the common hepatic artery we can see this artery coming out. This is the gastrodiodenal artery. The gastrodiodenal artery runs behind the first part of the diodenum and we can see it coming here and after that it gives rise to this branch here. This is the right gastrobial ploid and it gives rise to the next branch here. This is the superior pancreatic odenal and to see the same thing again from this side we can see the superior pancreatic odenal and the right gastrobial ploid. From the hepatic artery proper we can see right gastric artery coming out and it runs in the lesser curvature. Now I will lift up the head of the pancreas from the C loop of the diodenum and I will show you the superior mesentric artery. This is the superior mesentric artery and just to the right of the superior mesentric artery is the superior mesentric vein and we can see coming from the superior mesentric artery is this artery here. This is the inferior pancreatic odenal and we can see other portions of the inferior pancreatic odenal here also. Inferior pancreatic odenal runs from below and the superior pancreatic odenal runs from above and they form an astromotin arcade in this region and they supply both the head of the pancreas as well as the C loop of the diodenum. That is why wherever there is any cancer of the head of the pancreas which is not very uncommon we cannot separately dissect them out so we have to do what is known as pancreatic odenectomy also called the Wippel's procedure which is the very extensive procedure. So these are some of the structures which I wanted to show you in the C loop of the diodenum, the head of the pancreas, the blood supply and some abnormalities in this particular case namely the diodenal diverticulum. Thank you very much for watching. Dr. Sanjay Sanyal signing out. If you have any questions or comments please put them in the comment section below. Have a nice day.