Pancreas

• • soft, lobulates elongated gland
  • 12-15cm long extending from epigastrium to left upper quadrant (from concavity of duodenum to hilum of spleen opposite to t12-l3)
  • has endocrine and exocrine part
  • retroperitoneal except tail which is intraperitoneal

  
• Head of pancreas

  • enlarged, disc shaped right end of pamcreas
  • lies in concavity pf duodenum in front of l2 vertebr
  • related to 2 and 3 part of duodenum on right and is continues with neck on left
  • anterior suf is related to: gastroduodenal a, transverse colon and mesocolon,jujenum
  • posterior surface is related to inferior vena caba, left renal vein, bile duct, right crus of diaphragm.
  • contains uncinate process

  
• Neck of pancreas

  • Constricted portion connecting head and body
  • narrow band of pancreatic tissue that lies in front of origin of superior mesentery artery and confluence of portal vein (union of splenic and superior mesenteric veins)
  • anteriorsuperior border supports pylorus pf stomach
  • superior mesenteric vessel emerge from inferior border

  
• Tail of pancreas

  • Narrow, short segment, ending at the splenic hilum.
  • It is mobile (intraperitoneal) unlike other major retroperitoneal parts of the gland
  • contains the largest number of islets of Langerhans
  • Lies in the splenicorenal (lienorenal) ligament at the level of the T12 vertebra.

  ● Anteriorly, related to splenic flexure of colon.

  
• Parts pf pancreas

  • Head: enlarged part located in curve of the duodenum. It includes the uncinate process, which is a projection that extends posteriorly.
  • Neck: narrow part between head and body, located anterior to the superior mesenteric vessels.
  • Body: elongated part that extends to the left, passing anterior to the aorta and the vertebral column.
  • Tail: The tapering end that extends to the hilum of the spleen, passing within the splenorenal ligament.

  
• Body of pancreas

  • It runs upward and to left.
  • lies in front of the vertebral column at or just below transpyloric plane.
  • superior border shows one small conical projection: Tuber omentale. superior border is related celiac trunk, hepatic a, splenic vein.
  • Anterior surface is separated into anteriosup ans anterioinf by 2 layers of transverse mesocolon. anterosup is related to cavity of lesser sac and anteroinf is related to coils of jejunum and ileum, left colic flexure

  
• Pancreas is related anteriorly with

  1. Stomach separated by lesser sac
  2. transverse colon and mesocolon
• Pancreas is related posteriorly with

  • Bile dict
  • portal vein
  • splenic vein
  • IVC
  • Aorta
  • origin of superior mesenteric artery
  • left psoas major
  • left renal vessel
  • left kidney
  • hilum of spleen

  
• Pancreatic ducts

  • main duct: runs entire length pan pancreas beginning from tail
  • receives many tributaries from tail body neck and head except upper portion of head
  • joins common bile duct and together they open into hepatopancreatic ampulla of bater in 2 part of duodenal wall. The ampulla open into duodenum by means of major duodenal papilla.
• Accessory pancreatic duct of Santorini

  • Drain superior portion of head
  • runs parallel to main pancreatic duct
  • empties separately into second portion of duodenum at minor duodenal papilla. About 2-3 cm above major duodenal papilla.

  
• Blood supply of pancreas

  • Head and beck: ventral and dorsal anastomosis btw branches of pancreaticoduodenal artery.

  superior pancreaticoduodenal artery (hepatic + gastroduodenal artery) branches of celiac trunk; inferior pancreaticoduodenal artery (branch of SMA)

  • body and tail: branches of splenic artery

  
• Innervation of pancreas

  • Sympathetic: thoracic splanchinic nerve: inhibitory
  • parasympathetic: vagus: stimulates both endocrine and exocrine functions
• Venous drainage of pancreas

  • Head and. Eck: anterior and posterior venous arcades that firm from superior and inferior pancreaticoduodenal veins
  • body and tail: splenic vein which is a tributary of portal vein
• Lymphatic drainage of pancreas

  Rich network that drains into: 1. pyloric nodes, hepatic nodes, splenic nodes

  • Ultimately the efferent vessels drain into:

  celiac lymph nodes and superior mesenteric lymph nodes.
• Pancreas slide

  
• Pancreas histology

  
• Blood supply of pancreas

  • Splenic artery: supplied tail of pancreas
  • Celiac trunk gives common hepatic artery which branches into hepatic proper artery and gastroduodenal artery
  • grastroduodenal artery branches into anterior and posterior superior pancreaticoduodenal artery that anastomosis along head of pancreas forming arcades that supply head
  • Superior mesenteric artery gives anterior and posterior inferior pancreaticoduodenal artery

  
• Pancreas histology

  
• Pancreas histology