A tongue-shaped gland behind the stomach, its head cradled by the C of the duodenum and its tail reaching the spleen
Pancreas — from the Greek for 'all flesh'.
Anatomy · Organs & viscera
Pancreas
About 12 to 15 cm long, retroperitoneal
Upper abdomen · digestive and endocrine system
The pancreas is a long, tongue-shaped gland lying across the back of the upper abdomen, behind the stomach, at about the level of L1 to L2. Its head is nestled in the C of the duodenum, its body crosses in front of the aorta and left kidney, and its tail reaches the hilum of the spleen. It is both an exocrine gland, making digestive enzymes, and an endocrine gland, whose islets of Langerhans make insulin and glucagon.
How to spot them
- ▸A flattened, pinkish-yellow lobulated gland lying transversely behind the stomach, from the duodenum on the right to the spleen on the left
- ▸Four parts: head with the hook-like uncinate process, neck, body and tail
- ▸The head sits in the concavity of the duodenum; the tail lies in the splenorenal ligament
- ▸The main pancreatic duct runs along its length and joins the bile duct at the ampulla of Vater
What to know
A hook-shaped extension of its head that passes behind the superior mesenteric vessels
The uncinate process of the pancreas.
Its neck lies in front of the point where the superior mesenteric and splenic veins join to form the portal vein
The neck of the pancreas.
Islands of endocrine cells scattered through it, discovered by a German medical student in 1869
The islets of Langerhans in the pancreas, found by Paul Langerhans.
A tumour at its head often first shows as painless jaundice because it squeezes the bile duct
Pancreatic head cancer obstructing the common bile duct.
Its main duct joins the common bile duct to open on the major papilla of the duodenum
The main pancreatic duct (of Wirsung) of the pancreas.
Inflammation of this gland, often from gallstones or alcohol, causes severe upper abdominal pain that bores through to the back
Acute pancreatitis — the gland lies retroperitoneally behind the stomach.
Key ideas
- About 98 per cent of the gland is exocrine acinar tissue that makes amylase, lipase and proteases; the endocrine islets make up only 1 to 2 per cent.
- The gland lies in the retroperitoneum, so pain from pancreatitis is felt in the epigastrium and radiates to the back.
Quick-fire facts
- •It is 12 to 15 cm long and weighs about 80 to 100 g.
- •It lies at the transpyloric plane, about L1 to L2; the head is to the right of the midline and the tail is at the splenic hilum.
- •The splenic vein runs along the back of the body and tail and joins the superior mesenteric vein behind the neck to form the portal vein.
- •The pancreas is retroperitoneal except for its tail, which lies in the splenorenal ligament.
- •Behind it lie the inferior vena cava, the aorta, the left renal vein and the left kidney; in front lies the stomach with the lesser sac between.
- •The main pancreatic duct (Wirsung) usually joins the bile duct at the ampulla of Vater; the accessory duct (Santorini) opens at the minor papilla.
- •Arterial supply comes from the splenic artery and the gastroduodenal artery, via the superior pancreaticoduodenal arteries.
- •In cookery the pancreas (like the thymus) is sold as sweetbread.
- •Annular pancreas is a congenital condition in which pancreatic tissue encircles the duodenum.
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