Pancreas-Relations-Trauma of the Pancreas-Cancer of the Head of the Pancreas and the Bile Duct-The Pancreatic Tail and Splenectomy-Diagnosis of Pancreatic Disease

Pancreas

The pancreas is both an exocrine and endocrine gland.
 The exocrine portion of the gland function is  producing secretion that contains enzymes capable of hydrolyzing proteins, fats, and carbohydrates. islets of Langerhans  of the gland, the pancreatic islets (The endocrine portion), produces the hormones insulin and glucagon, which play a key role in carbohydrate metabolism.

It is is an elongated structure that lies in the epigastrium and the left upper quadrant. It is soft and lobulated and situated on the posterior abdominal wall behind the peritoneum. It crosses the transpyloric plane. The pancreas is divided into a head, neck, body, and tail.

The head of the pancreas is disc shaped and lies within the concavity of the duodenum. the uncinate process,is  A part of the head extends to the left behind the superior mesenteric vessels .

The neck which connects the head to the body is the constricted portion of the pancreas and. It lies in front of the beginning of the portal vein and the origin of the superior mesenteric artery from the aorta.

The body runs upward and to the left across the midline . It is somewhat triangular in cross section. The tail passes forward in the splenicorenal ligament and comes in contact with the hilum of the spleen

Relations

■■ Anteriorly: From right to left: the transverse colon and the attachment of the transverse mesocolon, the lesser sac, and the stomach

■■ Posteriorly: From right to left: the bile duct, the portal and splenic veins, the inferior vena cava, the aorta, the origin of the superior mesenteric artery, the left psoas muscle, the left suprarenal gland, the left kidney, and the hilum of the spleen

Trauma of the Pancreas

The pancreas is is well protected because it is deeply placed within the abdomen and  protected by the costal margin and the anterior abdominal wall. However, blunt trauma, such as in a sports injury when a sudden blow to the abdomen occurs, can compress and tear the pancreas against the vertebral column. The pancreas is most commonly damaged by gunshot or stab wounds. Damaged pancreatic tissue releases activated pancreatic enzymes that produce the signs and symptoms of acute peritonitis.

Cancer of the Head of the Pancreas and the Bile Duct

cancer of the head of the pancreas often causes obstructive jaundice Because of the close relation of the head of the pancreas to the bile duct,.

The Pancreatic Tail and Splenectomy

The presence of the tail of the pancreas in the splenicorenal ligament sometimes results in its damage during splenectomy. The damaged pancreas releases enzymes that start to digest surrounding tissues, with serious consequences

Diagnosis of Pancreatic Disease

The deep location of the pancreas sometimes gives rise to problems of diagnosis for the following reasons:

■■ Pain from the pancreas is commonly referred to the back.

■■ Because the pancreas lies behind the stomach and transverse colon, disease of the gland can be confused with that of the stomach or transverse colon.

■■ Inflammation of the pancreas can spread to the peritoneum forming the posterior wall of the lesser sac. This in turn can lead to adhesions and the closing off of the lesser sac to form a pseudocyst.