Pancreas

Question 1

Pancreas overview

Answer 1

• Neck of pancreas lies at (L1; in line with transpyloric plane)
• Lies posterior to stomach
• Secondary retroperitoneal except for tail of pancreas (lies in lienorenal ligament)

Functions:

1) Exocrine – pancreatic fluid released by acinar cells enters duodenum via hepatopancreatic ampulla
2) Endocrine – Insulin and glucagon release from islet of Langerhans enters bloodstream

Question 2

Relationship of anatomical parts

Answer 2

1) Tail
-lies in lienorenal ligament (intraperitoneal) at hilum of spleen
2) Body
-Peritoneum covers anterior surface
-Lies posterior to:
Bed of stomach
Floor of lesser sac
Transverse colon (body of pancreas lies in supracolic and infracolic compartments)
-Lies anterior to: Splenic vein
-Superior border: Splenic artery
3) Neck
-Lies anterior to:
SMA
SMV
Hepatic Portal vein
4) Head
-Cradled by duodenum
-Lies anterior to Hepatic Portal vein
5) Uncinate process
-Lies posterior to:
SMA
SMV

Question 3

Vasculature

Answer 3

Arterial:

1) Splenic artery
2) Anterior and posterior superior pancreaticoduodenal artery (branch of gastroduodenal artery)
3) Anterior and posterior inferior pancreaticoduodenal artery (branch of SMA)

Venous:

1) Head of pancreas –> Superior mesenteric branches of hepatic portal vein
2) Rest of pancreas –> Splenic vein

Question 4

Annular pancreas

Answer 4

• Ventral pancreatic bud is bi-fid and rotates in opposite directions around duodenum
• Can lead to constriction of duodenum and may result in complete obstruction

Question 5

Pancreatic pseudocyst

Answer 5

• Usually caused by pancreatitis / abdominal trauma

- Leads to accummulation of enzyme-rich fluid and blood in an area of pancreas

Question 6

Cancer in pancreatic head

Answer 6

• Accounts for most cases of extra-hepatic obstruction of biliary tree
• Leads to obstructive jaundice