The pancrease

Presentation as a overview of the organ of GI tract.
Pancreas.

1. The Pancreas

2. Introduction The pancreas is an elongated, tapered organ located across the back of the belly, behind the stomach . The right side of the organ—called the head—is the widest part of the organ and lies in the curve of the duodenum, the first division of the small intestine . The tapered left side extends slightly upward—called the body of the pancreas—and ends near the spleen—called the tail.

3. Size and Shape It is J – shaped or retort shaped, set obliquely. The bowl of the retort represents its head , and the stem of the retort , its neck , body and tail. It is about 15-20 cm long 2.5-3.8 cm broad and 1.2-1.8 cm thick and weighs about 90 g

4. Division The pancreas is divided ( from right to left ) into the head, the neck, the body and tail. The head is enlarged and lies within the concavity of duodenum. The tail reaches the hilum of the spleen. The entire organ lies posterior to the stomach separated from it by the lesser sac.

5. Head of Pancreas H e ad i s t he enla r ged flatt e ned ri g ht end o f t he pa n cre a s, sit u ated wi t hin the c u r ve o f d u o d en u m . The h e ad has th r ee b o r d e rs : s uperio r , i nfer i or an d rig h t later a l. It ha s two surfa c e s : a n terior an d p o sterior It has o n e p r ocess c a lled t he uncinate pr o cess, w h ich p r oje c ts fr om t he l o w er and left part of the hea d tow a rds left.

6. The s u perior border i s ove r lapped by the first pa r t of the d u odenum and i s r e lated t o the superior pan c reat i cod u ode n a l ar t er y . The in f e r ior borde r i s re l ated t o the third part of the d u odenum and t o the in f e rior pan c reat i cod u ode n a l ar t er y . The right la t e ral border i s related t o the se c ond pa r t o f the duodenum, the ter m inal p a rt of the b ile duct and the a n as t o mosis betwe e n the two pan c reat i cod u ode n a l ar t er i e s .

7. TWO S UR F ACES The ante r ior surfa c e is rel a ted , from a b o v e d o w n w a rds to 1.t h e ga s troduodenal artery 2 . the tra n v e rse c o lon, 3 . the jej u n u m w h ich s e p a r a ted fr o m it by p e rito n iu m .

8. The po s terior surf a ce i s related to 1 . the inf e rior ven a cava . 2 .the termi n al p a rts o f the re n al v e in 3 .the right crus of the dia p hra g m 4 .the bile duct

9. Neck of Pancreas This i s the sli g h t ly cons t rict e d part of t he p a n c r e as b e twe e n it s hea d an d bod y . It i s dir e cted for w ar d s, u p war d s an d t o the left. It has two surf a ces, ant e rior and po s terio r .

10. Bo d y of the pancreas The body of the pa n cre a s i s elo n gat e d . It e x ten d s from it s nec k t o the tai l . It p a sses towards t he left w i th a sli g ht upwa r d an d ba c kw a rd inclinatio n . It ha s 3 b o rd e rs, 3 sur f a c es

11. Three border The ant e rior bo r der pr o vides attachm e nt t o the r o ot o f the tra n sv e rse me s o c olo n . The su p erior bo r der i s re l ated t o co e l i ac t ru n k ov e r t he tuber oment a l e , t he hep a tic artery to the rig h t ,a n d the spl e nic a r tery t o the left. The i nf e ri o r bo r der i s r elated t o the su p erior m e s e nt e ric v e ssels a t it s rig h t end .

12. Tail of Pancreas This i s the narr o w left end of the pan c reas . I t l i es in the lieno r en a l lig a ment tog e th e r with the splenic vesse l s. I t comes into co n ta c t with the lower pa r t of the ga s tric surf a c e of the sp l een.

13. Ducts of Pancreas The ex o crine pa n cre a s i s d r ai n ed by two du c ts The main pancreatic duct ( wirsung’s duct) The accessory pancreatic duct (Santorini’s duct)

14. Arterial Supply Panc r e a t i c b r anches o f t h e sp l en i c ar t ery T he supe r i o r panc r e a t i c odu i odena l ar t e r y T he i n f eri o r panc r e a ti c odu o dena l ar t e r y .

15. Venous Drainage Vein drain into splenic, superior mesenteric and portal veins

16. Lymphatic drainage Rich per i aci na r n e t w or k th a t d r ain i n t o 5 nodal g r oups Super i o r nodes A n t er i o r no d es I n f er io r nodes P o s t er io r PD nodes Spl en i c nodes

17. The exocrine pancreas This cons i s t s of a la r ge number of lobules m a de up of s m all a c ini, the wa l ls of which consist of secretory cel l s. Ea c h lobule i s dr a ined by a t i ny du c t and th e se unite eventu a lly t o form the pancre a tic duct, w h ich extends the whole length of the gland a n d opens in t o the duodenu m . The function of the exocrine pancres is to produce pancreatic juice containing enzymes that digest carbohydrates, protein and fats.

18. The Endocrine Pancreas Distribu t ed t hr o ugh o ut t he gland are groups of s p e c ialised c e lls c a ll e d the pancre a tic is l ets (isl e ts o f lan g er h an s ). The end o crine p a ncre a s se c retes t he ho r mones in s ulin and glucagon, w h i ch are princ i p a ll y con c erned wi t h cont r ol of b l ood g l ucose le v el s . The islets have no duct so the hormones diffuse directly into the blood.

19. Cells Alpha c e l ls produce glucagon. Beta c el l s produce insulin. Del t a c e l ls p r o d u c e s o m a t o s t a ti n

20. Congenital Anomalies Congenital anomalies can be defined as structural or functional anomalies (for example, metabolic disorders) that occur during intrauterine life and can be identified prenatally, at birth , or sometimes may only be detected later in infancy