The duodenum is unique in its functions. It acts as a vestibule for the small intestine and is a meeting ground for the acid stomach ingesta and the alkaline biliary and pancreatic secretion. The four inches above this point partakes of the character of the stomach and its ills, and is more frequently diseased than any other part of the intestine of equal length, save the rectum. Duodenal ulcer is much more serious than gastric ulcer. The coats are much thinner and the danger of erosion of large blood vessels is much greater and the likelihood of sudden death from perforation make it a very fearful malady.
Its symptoms are not so frank, and, when present, are either construed as gastric or they mimic the manifestations of gall-bladder disease confusingly. It is in the operating room that the real living pathology of the duodenum is being developed, and it was
HAGGARD WD. THE SURGICAL TREATMENT OF DUODENAL ULCER.. JAMA. 1906;XLVII(5):338-341. doi:10.1001/jama.1906.25210050022002d