(pan=all and kreas=flesh)
Introduction...
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? Soft, lobulated
elongated gland
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with both exocrineand endocrine
functions
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? Exocrine ?
pancreatic
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juice? Endocrine-insulin,
Glucogan
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Location...
? epigastric & left
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hypochondriac
regions.
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? behind thestomach
and lesser sac
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? Transversely across
the posterior
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abdominal wall atthe level of L1 -
L3
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Size and shape..
? J shaped or
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retort shaped.
? Length-15-20 cm
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? Thickness-1.2-1.8 cm
? Breadth-2.5 -3.8
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cm
? Wt- around 90
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gmPARTS
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HEAD
Enlarged part C
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shaped, lying withinthe concavity of
duodenum, consist of
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? 3 borders-superior
,inferior & right lateral
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? 2 surfaces-anterior &Posterior
? uncinate process
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HEAD...
? Superior border-
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-1st part of duodenum
-Sup. PancreaticodudenalA.
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? Inferior border--3rd part of duodenum
-Inf. pancreaticodudenal A.
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? Rt. lateral border-
-2nd part of duodenum
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-Terminal part of bile duct-Anastomosis betn 2
arteries.
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HEAD...
Anterior surface
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? 1st part of
duodenum.
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? Transversecolon
? Jejunum
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separated by
peritotneum.
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HEAD...
Posterior
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surface:? IVC
? Right Renal
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veins
? Right crus of
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diaphragm? Bile duct
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UNCINATE PROCESSTriangular projection
which arises from
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lower and left part of
the body.
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Relations:? Anterior:
-Superior mesenteric
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vessels.
? Posterior
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-Aorta? Above
-Left renal vein
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NECK
Relations:
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Upper border:
. First part of
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DuodenumAnterior surface
? Peritoneum
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covering lesser sac
? Pylorus
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NECK..
Posterior surface
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is related to? superior
mesenteric vein
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? portal vein
BODY
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? Elongated part.
? Extends from neck to
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the tail.? Passes toward the
left with slight upward
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and backward
inclination
BODY...
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Triangular in cross
section
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? 3 borders--Anterior
-superior
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-Inferior
? Tuber omentale -
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small projectionon superior border
little to the left of
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the neck
BODY...
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Relations...
Borders:
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? Anteriorly attach toroot of the tranverse
mesocolon .
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? Superior related to
coeliac trunk,
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hepatic artery &splenic artery
? Inferior is related
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to
superior mesenteric
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artery.BODY..
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Relations...Surfaces:
? Anterior is convex
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covered by the
peritoneum related to
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the lesser sac &stomach.
? Inferior surface covered
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by the peritoneum
related the DJ flexure
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coils of jejunum & Lt.colic flexure.
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BODY..? Posterior surface
-Aorta
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-Left crus of the
diaphragm
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-Left kidney-Left Suprarenal
gland
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-Left renal vessels
-Splenic vein
TAIL
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? Left end of the
pancreas
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? Lies in thelienorenal
ligament ,together
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with the splenic
vessels
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? Related to thelower part of the
spleen (gastric
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surface.
DUCT SYSTEM
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Exocrine part
of pancreas is
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drained by the2 ducts
? Main
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? Accessory.
Main pancreatic duct of Wirsung
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? Lies near posterior
surface ,3 mm in
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diam.white in colour? Begins at the tail, runs
throughout the body
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,bends at the neck to
run downwards
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backwards in thehead.
? Herring bone pattern
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Herring bone pattern
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Main pancreatic duct of Wirsung? In the head of the
pancreas, it is related to
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the bile duct(on rt. side)
? Two ducts open in the
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wall of the 2nd part ofthe duodenum and join
to form
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hepatopancreatic
ampulla of vater which
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open as major duodenalpapilla,8-10 cm distal to
pylorus.
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Accessory duct of Santorini
? Begins in the lower
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part of head, crosses
the main duct with
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which it communicates? Opens as minor
duodenal papilla in
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the 2nd part of
duodenum (6-8 cm
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distal to pylorus)Arterial supply...
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-Splenic A.-Superior
pancreaticoduodenal
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artery
(from coeliac trunk)
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-Inferiorpancreaticoduodenal
A.(from
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superior mesenteric
Venous drainage
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-Splenic vein
-Superior
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mesentericVein
-Portal vein
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Nerve Supply
? Parasympathetic by
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the vagus nerve
controlling secretion .
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? Sympathetic fromcoeliac & superior
mesenteric plx.
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? Secretion is also
controlled by
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hormonesecretinpancreozymine
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DEVELOPMENTThe pancreas develops in
two parts, both of
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which arise from the
endoderm of the
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primitive duodenum.The ventral bud develops
more caudally as a
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diverticulum.
DEVELOPMENT
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DEVELOPMENTThe dorsal bud is the first to
appear, as a diverticulum from the
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dorsal wall of the duodenum. This
eventually forms the whole of the
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neck, body and tail of the gland,together with part of the head.
Between the fourth and eighth
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week, the ventral bud rotatesposteriorly in a clockwise fashion to
fuse with the dorsal bud.
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DEVELOPMENTAL ANOMALIESPANCREATIC DIVISUM
Most common congenital anomaly
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Results from failure of dorsal and ventral
ducts to fuse
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Detected in 5% to 10% of population inautopsy studies
ANNULAR PANCREAS
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Rare congenital anomaly
Ring of pancreatic tissue surrounds the
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duodenumMay be partial or complete
1 in every 12 000 to 15 000 live births
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DEVELOPMENTAL ANOMALIESECTOPIC PANCREAS
Described as pancreatic tissue that lacks anatomic or
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vascular continuity with the normal pancreas.
Usually asymptomatic and occurs as incidental
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finding.AGENESIS AND HYPOPLASIA
Total agenesis is extremely rare and incompatible
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with life.
Hypoplasia result from absence of ventral or dorsal
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pancreatic bud.DEVELOPMENTAL ANOMALIES
ACCESSORY PANCREATIC LOBE
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Extremely rare anomalyAccessory lobe of pancreatic tissue originating from
main pancreatic gland.
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May contain an aberrant duct
ANSA PANCREATICA
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Rare anatomical variation.Communication between main pancreatic and
accessory pancreatic duct.
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Predisposing factor in patients with idiopathic acute
pancreatitis.
CLINICAL CORRELATION
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1. Carcinoma of the head of pancreas
2. Acute Pancreatitis
PORTAL VEIN
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Hepatic Portal Vein
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? Origin & end in capillaries /venous
sinusoids
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? Size: 8cm X 1 cm
? Drains
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? Abdominal part of alimentarytract (except lower part of anal
canal)
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? Spleen & Pancreas
? Conveys absorbed products of
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digested food to liver? Devoid of valves
? Reservoir of blood : 1200 ml /
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min
Formation
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? Union of Sup mesenteric & Splenic vein
? Between neck of Pancreas & IVC at level L2
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