Skip to main content
SpringerLink
Log in

Anatomy and Physiology of the Stomach and Pylorus

  • Chapter
  • First Online:
The SAGES Manual of Foregut Surgery

Abstract

The stomach is divided into four segments that are important guides when you plan a surgical resection: (1) the cardia; (2) the fundus; (3) the corpus or body; and (4) the antrum. The cardia is the most proximal part of the stomach located immediately after the gastroesophageal junction. The fundus is the region of the stomach that extends above the gastroesophageal junction. The corpus or body lies between the fundus and the antrum and is marked distally by the angularis incisura, a notch on the lesser curvature of the stomach located near to the pyloric end. The last segment is the antrum, which extends from the corpus or body to the pyloric sphincter, a thick muscular valve that separates the antrum from the duodenum. Each of these segments has histologic differences and is involved in unique roles in the process of digestion.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Porrett PM, Drebin J. The surgical review: an integrated basic and clinical science study guide. Books Express (Portsmouth, NH, U.S.A): Lippincott Williams & Wilkins; 2015.

    Google Scholar 

  2. Soybel DI. Anatomy and physiology of the stomach. Surg Clin North Am. 2005;85(5):875–94.

    Article  Google Scholar 

  3. Garcia-Tsao G. Portal hypertension. Curr Opin Gastroenterol. 2006;22(3):254–62.

    Article  Google Scholar 

  4. Ikoma N, Blum M, Estrella JS, Wang X, Fournier KF, Mansfield PF, et al. Left gastric artery lymph nodes should be included in D1 lymph node dissection in gastric cancer. J Gastrointest Surg. 2017;21:1563.

    Article  Google Scholar 

  5. Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14(2):101–12.

    Article  Google Scholar 

  6. Lloyd KK. Peripheral regulation of gastric acid secretion. Physiol Gastrointest Tract. 1994;1:1185–226.

    Google Scholar 

  7. Ramsay PT, Carr A. Gastric acid and digestive physiology. Surg Clin North Am. 2011;91(5):977–82.

    Article  Google Scholar 

  8. Schubert ML, Peura DA. Control of gastric acid secretion in health and disease. Gastroenterology. 2008;134(7):1842–60.

    Article  CAS  Google Scholar 

  9. Schubert ML, Makhlouf GM. Gastrin secretion induced by distention is mediated by gastric cholinergic and vasoactive intestinal peptide neurons in rats. Gastroenterology. 1993;104(3):834–9.

    Article  CAS  Google Scholar 

  10. Saffouri B, DuVal JW, Arimura A, Makhlouf GM. Effects of vasoactive intestinal peptide and secretin on gastrin and somatostatin secretion in the perfused rat stomach. Gastroenterology. 1984;86(5 Pt 1):839–42.

    CAS  PubMed  Google Scholar 

  11. Yao X, Forte JG. Cell biology of acid secretion by the parietal cell. Annu Rev Physiol. 2003;65:103–31.

    Article  CAS  Google Scholar 

  12. Schubert ML. Functional anatomy and physiology of gastric secretion. Curr Opin Gastroenterol. 2015;31(6):479–85.

    Article  Google Scholar 

  13. Geibel JP. Role of potassium in acid secretion. World J Gastroenterol. 2005;11(34):5259–65.

    Article  CAS  Google Scholar 

  14. Eusebi LH, Rabitti S, Artesiani ML, Gelli D, Montagnani M, Zagari RM, et al. Proton pump inhibitors: risks of long-term use. J Gastroenterol Hepatol. 2017;32(7):1295–302.

    Article  Google Scholar 

  15. Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017;66(1):6–30.

    Article  CAS  Google Scholar 

  16. Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston textbook of surgery E-book. Elsevier (New York, NY, U.S.A.): Elsevier Health Sciences; 2016.

    Google Scholar 

  17. Meek CL, Lewis HB, Reimann F, Gribble FM, Park AJ. The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones. Peptides. 2016;77:28–37.

    Article  CAS  Google Scholar 

  18. Yakabi K, Kawashima J, Kato S. Ghrelin and gastric acid secretion. World J Gastroenterol. 2008;14(41):6334–8.

    Article  CAS  Google Scholar 

  19. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21(Suppl 1):S1–27.

    Article  CAS  Google Scholar 

  20. Chen D, Monstein HJ, Nylander AG, Zhao CM, Sundler F, Hakanson R. Acute responses of rat stomach enterochromaffinlike cells to gastrin: secretory activation and adaptation. Gastroenterology. 1994;107(1):18–27.

    Article  CAS  Google Scholar 

  21. Samloff IM. Pepsins, peptic activity, and peptic inhibitors. J Clin Gastroenterol. 1981;3(Suppl 2):91–4.

    CAS  PubMed  Google Scholar 

  22. Allen A, Pearson JP, Blackburn A, Coan RM, Hutton DA, Mall AS. Pepsins and the mucus barrier in peptic ulcer disease. Scand J Gastroenterol Suppl. 1988;146:50–7.

    Article  CAS  Google Scholar 

  23. Waldum HL, Hauso O, Fossmark R. The regulation of gastric acid secretion - clinical perspectives. Acta Physiol (Oxf). 2014;210(2):239–56.

    Article  CAS  Google Scholar 

  24. Chen MC, Sanders MJ, Amirian DA, Thomas LP, Kauffman G, Soll AH. Prostaglandin E2 production by dispersed canine fundic mucosal cells. Contribution of macrophages and endothelial cells as major sources. J Clin Invest. 1989;84(5):1536–49.

    Article  CAS  Google Scholar 

  25. Lindstrom E, Hakanson R. Prostaglandins inhibit secretion of histamine and pancreastatin from isolated rat stomach ECL cells. Br J Pharmacol. 1998;124(6):1307–13.

    Article  CAS  Google Scholar 

  26. Ramkumar D, Schulze KS. The pylorus. Neurogastroenterol Motil. 2005;17(Suppl 1):22–30.

    Article  Google Scholar 

  27. Minalyan A, Gabrielyan L, Scott D, Jacobs J, Pisegna JR. The gastric and intestinal microbiome: role of proton pump inhibitors. Curr Gastroenterol Rep. 2017;19(8):42.

    Article  Google Scholar 

  28. Lender N, Talley NJ, Enck P, Haag S, Zipfel S, Morrison M, et al. Review article: associations between helicobacter pylori and obesity--an ecological study. Aliment Pharmacol Ther. 2014;40(1):24–31.

    Article  CAS  Google Scholar 

  29. Bik EM, Eckburg PB, Gill SR, Nelson KE, Purdom EA, Francois F, et al. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci U S A. 2006;103(3):732–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Samuel Torres Landa & Kristoffel R. Dumon

  2. Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Daniel T. Dempsey

Authors
  1. Samuel Torres Landa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kristoffel R. Dumon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel T. Dempsey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristoffel R. Dumon .

Editor information

Editors and Affiliations

  1. University of Alabama at Birmingham , Birmingham, AL, USA

    Jayleen Grams

  2. The Ohio State University, Columbus, OH, USA

    Kyle A. Perry

  3. Brigham and Women’s Hospital, Boston, MA, USA

    Ali Tavakkoli

Rights and permissions

Reprints and permissions

Copyright information

© 2019 SAGES

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Landa, S.T., Dumon, K.R., Dempsey, D.T. (2019). Anatomy and Physiology of the Stomach and Pylorus. In: Grams, J., Perry, K., Tavakkoli, A. (eds) The SAGES Manual of Foregut Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-96122-4_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-96122-4_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96121-7

  • Online ISBN: 978-3-319-96122-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation