The stomach and small intestinal wall are made of 4 distinct layers including the mucosa, submucosa, muscularis, and serosa. The stomach and small intestine venous drainage terminate in the portal vein. This subdivides into 12–15 major branches that course along the mesentery and divide into the vasa recta, which extends into the intestinal wall. This is in contrast to the blood supply to the small intestine which receives input from the cranial mesenteric artery, which exists within the root of the mesentery. The celiac artery divides into the left gastric, splenic, and hepatic artery, all of which provide distinct blood supply to different segments of the stomach. Blood supply to the stomach arises from the celiac artery, a direct tributary from the abdominal aorta. The duodenum receives secretions from the gallbladder via the common bile duct, and the pancreas via accessory and pancreatic ducts, which provide essential roles in nutrient digestion and absorption, as well as maintaining barrier function of the gastrointestinal tract. Large intestinal disease and surgery is beyond the scope of this discussion. The small intestine is divided into the duodenum, jejunum, and ileum, which terminates into the large intestine. The pyloric section of stomach includes both the antrum, which is the region of the outflow tract, and the pyloric sphincter, which is composed of two muscle layers. The body of the stomach spans from the fundus to the pylorus. The section of stomach that is joined to the esophagus is the cardia, which blends into the blind-ended pouch of the stomach, or the fundus. The stomach is made of 4 compartments: the cardia, fundus, body, and pyloric portions. Finally, new relevant literature and subsequent clinical impact will be summarized. Surgical complications will be reviewed as well as complication management. In this session, common causes of surgical intestinal disease will be reviewed as well as surgical technique for the most common types of intestinal surgery, such as enterotomy, gastrotomy, and intestinal resection and anastomosis.
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