Three-dimensional arrangement of dense connective tissue around the human major duodenal papilla. Including the ampullary region and the distal choledochal duct.

Directionally arranged dense connective tissue fibres were investigated in 21 specimens of the major duodenal papilla. Specimens were examined using a stereoscope, polarization microscopy and serial histological sections at three different planes. Directionally arranged dense connective tissue fibres spread in a deltoid pattern from the orifice of the major duodenal papilla and its intraduodenal part to the circular duodenal musculature. Connective tissue fibres crossing at different angles form a texture from the orifice of the major duodenal papilla to the distal choledochal duct. The functional significance of the dense connective tissue fibres, e.g. for the muscular system in the investigated area, is discussed as well as possible reasons for gallstone impactions.