Foregut
Territory · Oesophagus → D2 papilla Epigastric pain
Embryological gut segment supplied by the coeliac trunk: abdominal oesophagus, stomach, first and second parts of the duodenum to the major papilla, liver, gallbladder, pancreas and spleen. Visceral pain from these organs travels with the greater splanchnic nerves to T5–T9 and is felt in the epigastrium.
Traced from the start
Detail
- Extent
- Abdominal oesophagus to the major duodenal papilla, plus liver, biliary tree, pancreas and spleen
- Arterial supply
- Coeliac trunk (T12)
- Referred pain
- Epigastrium (T5–T9, greater splanchnic nerve)
When it goes wrong
Peptic ulcer, early cholecystitis, pancreatitis
Poorly localised epigastric visceral pain; the coeliac plexus is the target of a coeliac plexus block for unrelenting pancreatic pain
Practise this structure
2 questions in the bank tagged Referred Pain.
A 22-year-old man is struck in the left lower chest by a cricket ball. Two hours later he has constant pain at the tip of the left shoulder, worse when he lies…
Foundations · common
A 62-year-old man has had 4 months of worsening constipation with cramping pain that comes in waves and eases after a few minutes; he cannot point to one spot w…
Foundations · middle twist