Pancreas

The pancreas is a long, soft organ that lies in the abdomen that plays an important role in both the endocrine system and digestion.

Pancreas

Pancreas

Anatomy

The pancreas lies transversely along the posterior abdominal wall, posterior to the stomach, and extends from the region of the duodenum to the spleen.

Etiology

The word pancreas is from the Greek πᾶν (pân, “all”) & κρέας (kréas, “flesh”).

Structure

The pancreas is an intra-abdominal organ that in humans lies in the abdomen, stretching from behind the stomach to the left upper abdomen near the spleen.

Digestive diagram

Parts of pancreas

Anatomically, the pancreas is divided into a head, neck, body, and tail. The pancreas stretches from the inner curvature of the duodenum, where the head surrounds two blood vessels: the superior mesenteric artery, and vein.

Blood supply

The pancreas has a rich blood supply, with vessels originating as branches of both the coeliac artery and superior mesenteric artery.

The body and neck of the pancreas drain into the splenic vein, which sits behind the pancreas and the head drains into, and wraps around, the superior mesenteric and portal veins, via the pancreaticoduodenal veins.

The lymphatic vessels of the body and tail drain into splenic lymph nodes, and eventually into lymph nodes that lie in front of the aorta, between the coeliac and superior mesenteric arteries. The lymphatic vessels of the head and neck drain into intermediate lymphatic vessels around the pancreaticoduodenal, mesenteric and hepatic arteries, and from there into the lymph nodes that lie in front of the aorta.

Inflammation of the pancreas is known as pancreatitis, with common causes including chronic alcohol use and gallstones. Because of its role in the regulation of blood sugar, the pancreas is also a key organ in diabetes mellitus. Pancreatic cancer can arise following chronic pancreatitis or due to other reasons, and carries a very poor prognosis, as it is often identified when it has spread to other areas of the body.

Function

Pancreas is one of very few organs in the body that has both endocrine and exocrine functions.

Pancreatic duct

Pancreatic duct

Exocrine fuction

The pancreas has an exocrine portion that secretes digestive enzymes that are carried through a duct called pancreatic duct to the duodenum.

Endocrine function

The endocrine portion consists of the pancreatic islets, which secrete glucagons and insulin.

• The alpha cells in the pancreatic islets secrete the hormone glucagon in response to a low concentration of glucose in the blood.
• Beta cells in the pancreatic islets, called islets of Langerhans, secrete the hormone insulin in response to a high concentration of glucose in the blood.

Pancreatic disorders

Pancreas cancer world map - Death - WHO 2004

Pancreas cancer world map - Death - WHO 2004

• Acinar cell carcinoma of the pancreas

• Acute pancreatitis

• Autoimmune pancreatitis

• Chronic pancreatitis

• Congenital hyperinsulinism

• Cystic fibrosis

• Exocrine pancreatic insufficiency

• Hemosuccus pancreaticus

• Hereditary pancreatitis

• Hyperglycemia

• Hyperinsulinemia

• Hyperinsulinemic hypoglycemia

• Hyperinsulinism

• Hyperproinsulinemia

• Hypoglycemia

• Idiopathic hypoglycemia

• IgG4-related disease

• Impaired fasting glucose

• Impaired glucose tolerance

Pancreatic Tissue

• Insulitis

• Intraductal papillary mucinous neoplasm

• Ketotic hypoglycemia

• List of causes of hypoglycemia

• Nesidioblastosis

• Oxyhyperglycemia

• Pancreatic abscess

• Pancreatic cancer

• Pancreatic cyst

• Pancreatic disease

• Pancreatic fistula

• Pancreatic mucinous cystic neoplasm

• Pancreatic pseudocyst

• Pancreatic serous cystadenoma

• Pancreatic tumor

• Pancreatitis

• Pancreatoblastoma

• Reactive hypoglycemia

• Shwachman–Diamond syndrome

• Stress hyperglycemia

• Type 3c (pancreatogenic) diabetes

• Zollinger–Ellison syndrome