Anterior sur rleted peritoneum covering the post wall of the lesser sac n pylorus . Post surface relaated to termination of sup mesentric vein and beginning of portal vein
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
CONTENTS:- Introduction Development in detail Location………………………………….…… Relations……………………………………… -Peritoneal -Visceral Morphological Part………………………. -Head -Neck - Body -Tail Secretory Parts………………………………. -Exocrine -Endocrine Pancreatic Duct…………………………….. Applied Aspects………………………………………
:~ P ANCREAS ~• PAN – ALL• CREAS ~ FLESH:~ PANCREAS WAS FIRST DISCOVERED BYHEROPHILUS :~ ALSO DISCOVERED LIVER , EYE & MEASURED PULSE . :~ FIRST TO PERFORM PUBLIC DISSECTIONS ON HUMAN CORPSES .
Steve JobsCEO Apple Inc. diedwith PancreaticTumour
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
-Ventral bud & Dorsal bud.~ It arises at the junction of foregut& midgut .-They develop in relation to thesecond part of duodneum.- Ventral bud is in relation to thehepatic bud at the inferior angle.- Dorsal bud grows into the dorsalmesogastrium.
:~ After rotation of the gut , theventral bud come s to the rightand dorsal bud to the left .Note------------:~due to the Differential growth ofthe developing gut ~ buds come tolie on the same side .
1. Annular Pancreas2. Pancreatic Divisum3. Anamolies Of The Duct4. Ectopic Pancreas
1. ANNULAR PANCREAS :~ A rare condition --- second part of duodenum is surrounded by a ring of pancreatic tissue continuous withit’s head .~This portion of pancreas can constrict theduodenum and impairs the flow of food
A) CAUSES::~ Bifid ventral bud ~ fusion with dorsal bud ~ pancreatic ring .:~ Improper rotation of ventral pancreatic bud O rdorsal bud rotates in the wrong direction
:~ Postnatal diagnostic proceduresinclude abdominal X-ray ,ultrasound &CT scan .A RARE CASE OF AmpullARy CARCinOmAASSOCiAtEd with AnnulAR pAnCREAS iSBEinG ShOwn
2. PANCREATIC DIVISUM ::~ Most common congenital anomaly.:~ Ventral and Dorsal buds fail to fuse.:~ The body , tail and part of head ofpancreasdrain into the duct of SANTORINI intominorduodenal papilla .:~ The rest of the head with uncinateprocessdrains through the duct of WIRSUNG into
A) Normal (50%).B) Absence of communication betweennormally sited accessory duct and mainducts (10%).C) Persistance of complete ventraland dorsal ducts with separatedrainage (5%).B and C are both forms of ‘pancreasdivisum.D)Absence of accessory duct (20%).E) Conjoined drainage of persistantventral and dorsal ducts (<5%).
3. ECTOPIC PANCREAS~ ECTOPIC means------ away fromnormal-EVIDENCE TO PROOVEIt includes all histological elements ofboth exocrine and endocrinepancreas.~The ducts of the exocrine pancreas are not arranged in the normalanatomical pattern .
A) CAUSE : UNKNOWN:~Maybe due to hypoplasia of the ventral pancreaswhich causes rudimentary ventralpancreatic duct .
:~The pancreatic tissue maybe functionally active and secreting leading toulceration of the mucosa ,Pancreatitis with psuedocyst formation ,malignant or benign pancreatic tumour .
:~it can be presentOutside the Gastrointestinal tractin the wall of GALL BLADDER , LIVER , hilum of SPleen
Morphological Parts HEAD Thickest & broadest Lies in C- shaped curve – duodenum 3 borders – superior, inferior, rt lateral 2 surfaces – anterior & posterior Uncinate process
Morphological parts Neck Portal vein Constricted part 2 surfaces - anterior and posterior RelationsSup mesentric Anterior – peritoneumvein pylorus Posterior – sup mesentric vein portal vein
Morphological Parts Body Elongated part 3 borders – anterior, superior, inferior Part of superior margin projects upwards – ‘Tuber omentale’ 3 surfaces – Anterior, posterior, inferior
Tail•Narrowest•Between layers of splenorenalligamentRelations•Posteriorly – Splenic artery & vein•At the tip – Splenic hilum
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’‘
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
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
BlOOd Supply:Celiac Trunk- artery of the foregut.Superior Mesenteric artery- artery of the midgut.
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.
VENOUS DRAINAGE:Drained by the pancreaticoduodenal veins which end up in the portal vein . The portal vein is formed by the union of thesuperior mesenteric vein and splenic vein posterior to the neck of the pancreas.
VENOUS DRAINAGE: The inferior mesenteric vein joins with the splenic vein behind the pancreas . It may also join the superior mesentric vein.
LYMPHATIC DRAINAGE A network of lymphatic vessels exists within the pancreas. The majority of vesselslie in the interlobular septa of connective tissue( that subdivide the pancreas into lobes and lobules.)
Duct SystemIntralobular Ducts:Also called as Intercalated Duct.Lined by Squamous or very Low CuboidalEpithelium.Begins within the Acinus therefore surrounded byAcinar cells.Cells of Intercalated ducts secrete Bicarbonate ions. The Acinar lumen shows pale staining cells ofIntercalated Duct called Centroacinar Cells.
Interlobular Ducts:Lined by Simple Columnar Epithelium.These ducts are present in the septa.Main Duct:Lined by Tall Columnar Cells with Goblet cells inbetween.
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