The document discusses the pancreas and provides details about its location, morphology, blood supply, histology and more. Key points include: - The pancreas is located transversely across the posterior abdominal wall behind the stomach from the duodenum to the spleen. - Morphologically it has a head, neck, body and tail. - It functions as both an exocrine gland that secretes enzymes and an endocrine gland that produces hormones like insulin and glucagon. - The main pancreatic duct drains the gland and opens into the duodenum along with the common bile duct. - The pancreas has both exocrine and endocrine components and its histology and blood supply are

2. WHY PANCREAS IS SELECTED?
 Pancreatic cancer is a silent killer- one of the
most difficult tumors to detect and diagnose
early.
 Its cancer has the lowest survival rate .
 In most cases, symptoms develop after
metastases.
 Many organizations across the globe have now
taken initiative to bring awareness in the public
regarding the effects of this cancer
 Common region – in head of pancreas

3. CONTENTS:-
 Introduction
 Development in detail
 Location………………………………….……
 Relations………………………………………
-Peritoneal
-Visceral
 Morphological Part……………………….
-Head
-Neck
- Body
-Tail
 Secretory Parts……………………………….
-Exocrine
-Endocrine
 Pancreatic Duct……………………………..
 Applied Aspects………………………………………

4. :~ P ANCREAS ~
• PAN – ALL
• CREAS ~ FLESH
:~ PANCREAS WAS FIRST DISCOVERED BY
HEROPHILUS
:~ ALSO DISCOVERED LIVER , EYE & MEASURED PULSE .
:~ FIRST TO PERFORM PUBLIC DISSECTIONS ON
HUMAN CORPSES .

5. Steve Jobs
CEO Apple Inc. died
with Pancreatic
Tumour

7. Introduction
 “Mixed gland”, or compound gland- functions as both
-Endocrine gland
-Exocrine gland
 Yellowish Organ,jshaped or retort shaped
-12 to 15cms long
-3 to 4 cms wide
 Weight : 60-100g (Avg wt: 80g)
M>F

8. -Ventral bud & Dorsal bud.
~ It arises at the junction of foregut
& midgut .
-They develop in relation to the
second part of duodneum.
- Ventral bud is in relation to the
hepatic bud at the inferior angle.
- Dorsal bud grows into the dorsal
mesogastrium.

9. :~ After rotation of the gut , the
ventral bud come s to the right
and dorsal bud to the left .
Note------------
:~due to the Differential growth of
the developing gut ~ buds come to
lie on the same side .

11. PARTS OF PANCREAS

12. DUCT SYSTEM OF
PANCREAS

15. 1. Annular Pancreas
2. Pancreatic Divisum
3. Anamolies Of The Duct
4. Ectopic Pancreas

16. 1. ANNULAR PANCREAS :
~ A rare condition
--- second part of duodenum is surrounded by
a ring of pancreatic tissue continuous with
it’s head .
~This portion of pancreas can constrict the
duodenum and impairs the flow of food

17. A) CAUSES:
:~ Bifid ventral bud ~ fusion with
dorsal bud ~ pancreatic ring .
:~ Improper rotation of ventral
pancreatic bud
O r
dorsal bud rotates in the wrong
direction

18. :~ Postnatal diagnostic procedures
include abdominal X-ray ,
ultrasound &
CT scan .
A RARE CASE OF AmpullARy CARCinOmA
ASSOCiAtEd with AnnulAR pAnCREAS iS
BEinG ShOwn

20. NORMAL POSITION OF PANCREAS

21. ANNULAR PANCREAS

22. 2. PANCREATIC DIVISUM :
:~ Most common congenital anomaly.
:~ Ventral and Dorsal buds fail to fuse.
:~ The body , tail and part of head of
pancreas
drain into the duct of SANTORINI into
minor
duodenal papilla .
:~ The rest of the head with uncinate
process
drains through the duct of WIRSUNG into

23. m.R.i. SCAn ShOwinG pAnCREAtiC
diviSum

24. A) Normal (50%).
B) Absence of communication between
normally sited accessory duct and main
ducts (10%).
C) Persistance of complete ventral
and dorsal ducts with separate
drainage (5%).
B and C are both forms of ‘pancreas
divisum'.
D)Absence of accessory duct (20%).
E) Conjoined drainage of persistant
ventral and dorsal ducts (<5%).

25. 3. ECTOPIC PANCREAS
~ ECTOPIC means------ away from
normal-
EVIDENCE TO PROOVE
It includes all histological elements of
both exocrine and endocrine
pancreas.
~The ducts of the exocrine pancreas are
not arranged in the normal
anatomical pattern .

26. A) CAUSE :
UNKNOWN
:~Maybe due to
hypoplasia of the ventral pancreas
which causes rudimentary ventral
pancreatic duct .

27. :~
The pancreatic tissue maybe
functionally active and secreting leading to
ulceration of the mucosa ,
Pancreatitis with psuedocyst formation ,
malignant or benign pancreatic tumour .

28. :~
it can be present
Outside the Gastrointestinal tract
in the wall of GALL BLADDER ,
LIVER ,
hilum of SPleen

29. Ectopic pancreas in the galbladder

30. :~
Ectopic pancreatic tissue
can be discovered in
stomach ,
proximal part of jejenum ,
ileum ,
duodenum &
meckel’s diverticulum .

31. ECTOPIC PANCREAS SEEN
ALONG THE
THE GREATER CURVATURE
OF THE STOMACH

32. GAStRiC ECtOpiC
pAnCREAS
m.R.i. SCAn

34. C) ECTOPIC PANCREAS IN ILEUM :
PANCREATIC TISSUE
PANCREATIC TISSUE

35. :~
GROSS AnAtOmy

36. Location
 Transversely Across - Posterior abdominal wall
 Behind Stomach
 From Duodenum to Spleen
 Level of L1 & L2
 Occupies Epigastric and
Hypochondriac regions

37. Location
Located
transversely
across the
posterior
abdominal wall

38. Location
Behind the
Stomach
from
duodenum
to
Spleen

39. Location
Level of L1&L2

40. Epigastric & hypochondriac regions

41. Relations
Peritoneal
Retroperitoneal except for a small part of its tail.

42. Peritoneal relations
P
P

44. Visceral relations

45. Morphological Parts
Head
Neck
Body
Tail

46. Morphological Parts
HEAD
 Thickest & broadest
 Lies in C- shaped curve –
duodenum
 3 borders – superior,
inferior, rt lateral
 2 surfaces – anterior &
posterior
 Uncinate process

47. Morphological parts
Neck
Portal vein
 Constricted part
 2 surfaces - anterior and
posterior
 Relations
Sup mesentric Anterior – peritoneum
vein
pylorus
Posterior – sup mesentric vein
portal vein

48. Morphological Parts
Body
 Elongated part
 3 borders – anterior,
superior, inferior
 Part of superior margin
projects upwards – ‘Tuber
omentale’
 3 surfaces – Anterior,
posterior, inferior

49. Tail
•Narrowest
•Between layers of splenorenal
ligament
Relations
•Posteriorly – Splenic artery & vein
•At the tip – Splenic hilum

50. Main Pancreatic Duct
 Also called ‘Duct of Wirsung’ and Major Pancreatic Duct
 Begins in the tail
 Runs the length receiving channels – ‘Herring bone pattern’
 Pancreatic duct with common bile duct form -----------------
Hepatopancreatic Ampulla of Vater’
‘

51. Herring Bone

52. Main Pancreatic Duct

53. Main Pancreatic Duct
 Opens in 2nd part of duodenum along with bile duct on the
major duodenal papilla
 25% - duct opens into duodenum separately
 ‘Hepatopancreatic sphincter ( of Oddi)’
around the ampulla – smooth muscle controls flow of
secretions

54. Hepatopancreatic ampulla

55. Accessory Pancreatic Duct
 ‘Duct of Santorini’
 Opens into the duodenum at the summit of the minor
duodenal papilla
 (60%), the accessory duct communicates with the main
pancreatic duct
 Note - Some cases, the main pancreatic duct is smaller than
the accessory pancreatic duct and the two are not connected

56. Accessory Pancreatic Duct

58. DISSECTION

77. BlOOd Supply OF pAnCREAS:

78. BlOOd Supply:
Celiac Trunk- artery of the
foregut.
Superior Mesenteric artery-
artery of the midgut.

79. ARtERiAl Supply
 is derived from branches of the
 gastroduodenal artery and inferior mesenteric artery.
 These are superior pancreaticoduodenal artery and
inferior pancreaticoduodenal artery respectively.
 The gland is mainly supplied by pacreatic branches of
the splenic artery.

80. BLOOD SUPPLY TO PANCREAS

81. ARTERIAL SUPPLY OF
PANCREAS

83. ARTERIAL SUPPLY OF
PANCREAS:

85. VENOUS DRAINAGE:
Drained by the pancreaticoduodenal veins which end
up in the portal vein .
 The portal vein
 is formed by the union of the
superior mesenteric vein and splenic vein
posterior to the neck of the pancreas.

86. VENOUS DRAINAGE:
 The inferior mesenteric vein joins with the splenic
vein behind the pancreas .
 It may also join the superior mesentric vein.

87. VENOUS DRAINAGE:

88. nERvE Supply tO
pAnCREAS

89. NERVE SUPPLY TO
PANCREAS:

90. nERvE Supply:
 Sympathetic nerves are vasomotor .
 Parasympathetic nerves controls the pancreatic
secretion .

91. nERvE Supply tO
pAnCREAS

92. LYMPHATIC DRAINAGE
 A network of lymphatic vessels exists within the
pancreas.
 The majority of vessels
lie in the interlobular septa of connective tissue
( that subdivide the pancreas into lobes and lobules.)

93. lymphAtiC dRAinAGE

94. lymphAtiC dRAinAGE
 Lymphatics follows the arteries
 Drain into
 pancreaticosplenic ,
 coeliac
 superior mesentric groups of lymph nodes .

95. lymphAtiC dRAinAGE

96. hiStOlOGy OF
pAnCREAS:

97. EXOCRinE hiStOlOGy

98. H&E Stain

99. Exocrine Pancreas

100. PANCREATIC ACINI

102. H & E Stain

103. DUCT SYSTEM OF PANCREAS

104. Duct System
Intralobular Ducts:
Also called as Intercalated Duct.
Lined by Squamous or very Low Cuboidal
Epithelium.
Begins within the Acinus therefore surrounded by
Acinar cells.
Cells of Intercalated ducts secrete Bicarbonate ions.
 The Acinar lumen shows pale staining cells of
Intercalated Duct called
Centroacinar Cells.

105. Interlobular Ducts:
Lined by Simple Columnar Epithelium.
These ducts are present in the septa.
Main Duct:
Lined by Tall Columnar Cells with Goblet cells in
between.

106. H & E stain

107. Endocrine Histology

108. Islets of Langerhan-Different Cell
types

109. EndOCRinE
hiStOlOGy

110. Cells Types of islets

112. ACKNOWLEDGEMENTS
 THANKS TO MANAGEMENT OF SHADAN
MEDICAL COLLEGE.
 THANKS TO THE DEPARTMENT OF SURGERY
 SECIALLY TO CHANDRAMALA MADAM, RAMESH
SIR.
 THANKS TO THE DEPATMENT OF ANATOMY.
 THANKS TO THE STUDENTS OF FIRST YEAR
STUDENTS FOR HELPING ME IN THE
PREPARATION OF SEMINAR