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Wednesday, 13 April 2011

Pancreas anatomy

The ultrasonographic anatomy of the pancreas, look for the splenic vein to find the pancreas.

The splenic vein joins the superior mesenteric vein to form the portal vein.

The pancreas normally has an echogenic fatty ultrasonographic texture.

Vascular anatomy arround the pancreas:

Parts and anatomic relations
  1. Head
    • lies within the curve of the duodenum
    • uncinate process is a prolongation of the head. The superior mesenteric artery and vein crosses this process.
  2. uncinate process
    • the part of the head that wraps behind the superior mesenteric artery and vein and comes to lie adjacent to the ascending part of the duodenum.
  3. Neck
    • a constricted portion to the left of the head. It abuts the pylorus above and the beginning of the portal vein behind.
  4. Body
    • anterior surface separated from the stomach by the omental bursa
    • posteriorly related to the aorta, splenic vein, left kidney and renal vessels, left suprarenal, origin of superior mesenteric artery and crura of diaphragm.
  5. Tail
    • extends into the lienorenal ligament and abuts the spleen

Pancreatic duct (Wirsung)

Whats the clinical significance?
Compression, obstruction or inflammation of the pancreatic duct may lead to acute pancreatitis. The most common cause for obstruction is choledocholithiasis, or gallstones in the common bile duct. Obstruction can also be due to Duodenal Inflammation in Crohn's Disease. A gallstone may get lodged in the constricted distal end of the ampulla of Vater, where it blocks the flow of both bile and pancreatic juice into the duodenum. Bile backing up into the pancreatic duct may initiate pancreatitis.

The mean diameter of the duct in the area of the head-neck 3 mm, in the body proximal and distal to the neck, duct diameters were 2.1 and 1.6 mm, respectively.

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