THE PANCREAS

DEVELOPMENT:

• Starts out with a dorsal and ventral pancreatic bud on either side of the duodenum.
• The ventral bud rotates 180 and joins the dorsal bud.
• The stalk to the ventral bud becomes the major papilla
• The main pancreatic duct is formed from both dorsal and ventral buds.
• Annular Pancreas: The pancreatic lobes migrate around duodenum in the wrong direction and fuse with each other, strangling the duodenum.
• Can completely block or at best result in stenosis of duodenum.
  

LOCATION:

· Retroperitoneal.

· Umbilical, Epigastric, and left hypochondriac regions.

· It traverses diagonally from the descending (second) duodenum all the way over to the spleen.

EXTERNAL MORPHOLOGY:

• Head -- snug up against the second and third parts of duodenum.
• Lower portion extending inferiorly from the head is the uncinate process.
• Neck -- directly anterior to superior mesenteric artery and veins, and the portal vein.
• Body
• Tail: The tail of the pancreas extends into the splenorenal ligament, associated with the spleen.
  

INTERNAL MORPHOLOGY:

• There is a main pancreatic duct running down the center of the organ.
  

RELATIONSHIPS:

• The root of the transverse mesocolon runs along the longitudinal axis of the pancreatic, directly anterior to it. (So the transverse colon lies on top of it).
• Left Adrenal Gland and Left Kidney are just posterior to the body and tail of the pancreas.
  

CLINICAL CONSIDERATIONS:

• Referred epigastric pain could be the pancreas or the gallbladder. If the pain wraps around the posterior, too, then the bile duct is probably compressed (stenosis) which could be more serious than just gallbladder.
• Pancreatitis: causes
• Gallstones can block the major papilla in the duodenum. This would cause bile to backflow into the pancreas.
• A stenosis in the pancreatico-hepatic duct can cause acid chyme to backflow into the pancreas.
• The stones may block both common bile and pancreatic ducts above, causing both to backflow into pancreas.
  

VASCULAR / LYMPH SUPPLY:

• Superior Pancreaticoduodenal Arteries (Anterior and Posterior): These come off of the common hepatic, in turn off of the Celiac Trunk.
• They also anastomose with the Right Gastroepiploic.
• They supply the head, generally.
• Great Pancreatic Artery, and Inferior Pancreatic Artery, come off the Splenic Artery, from the Celiac Trunk.
• Supplies body and tail.

Category: Anatomy Notes