Pancreas

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The pancreas is located in the left hypophondrium and epigatric regions. It produces large amounts of enzymes that enter the duodenum through the pancreatic duct. It also contains islets of cells producing the hormones insulin and glucagon. The pancreas is both an exocrine gland, releasing its secretions through a duct system and an endocrine gland where the secretory product is released directly into the blood.

As an endocrine gland, the pancreas secretes hormones (such as insulin and glucagon) to regulate blood sugar levels.

As an exocrine gland, by way of the pancreatic duct, the pancreas secretes pancreatic juices into the duodenum to neutralize the acidic contents entering from the stomach.

The main pancreatic duct and the accessory pancreatic duct, unite with the common bile duct at the ampulla of Vater. This duct opens into the first part of the duodenum and the release of it is surrounded by the sphincter of Oddi.

In the adult, the pancreas is a retroperitoneal organ that measures 15 -20 cm in length and its anatomical relations can be described as:

Anteriorly - transverse colon, lesser sac, and stomach
Posteriorly - bile duct, portal and splenic veins, inferior vena cava, aorta, left suprarenal gland, and left kidney
Medially - curvature of duodenum
Laterally - Hilum of spleen

The parts of the pancreas can be categorized as:

Blood supply:

  1. The anterior and posterior superior pancreaticoduodenal arteries and the anterior and posterior inferior pancreaticoduodenal arteries supply the head and neck of the pancreas.

  2. The dorsal pancreatic artery, the great pancreatic artery and the caudal pancreatic artery supply the body and tail of the pancreas.

Venous drainage:

  1. The splenic vein and the superior mesenteric vein drain the pancreas.

Innervation:

It receives parasympathetic innervation from the vagus nerve. It receives sympathetic innervation from the great splanchnic nerve.

Clinical Notes:

  1. In the event of a pancreatic rupture, pancreatic juices will seep to surrounding structures and damage them.

  2. Pancreatic cancer might result in obstructive jaundice if it compresses adjacent structures.