Pancreas: in Situ View – Pancreas and Spleen

by James Pickering, PhD

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    00:01 So if we were to just look at the position of the pancreas and that is best done with all of the vast majority of the organs removed. So what we can see is the large intestines which would be here and here have been removed.

    00:15 The small intestine except the duodenum, which is positioned here has been removed.

    00:22 And that really gives us a clear window onto the floor of the the abdominal cavity onto the kind of the posterior wall of the abdominal cavity where we can just may count the pancreas. The stomach is being removed as well. We can see the pancreas would be in this position. Straddling line over the L1, 2 lumbar vertebra. We can see where the stomach would be that's gone opening here for the oesophagus that's passing through the diaphragm. And these would be connected up in this kind of arrangement where we have the stomach sheilding the pancreas.

    00:59 So the pancreas is a retroperitoneal organ except for the tail that passes to the hilum of the spleen within what's known as the splenorenal ligament.

    01:11 The tail of the pancreas passes to the spleen with the splenorenal ligament that contains the splenic artery and the splenic vein.

    01:20 The root of the transverse mesocolon originates and we can see that the cuttage of the transverse mesocolon here so that's the root of the transverse mesocolon. And it forms the posterior boundary of the omental bursa; posterior boundary of the omental bursa.

    01:38 Here we have added a few more organs, few more details. We can see we have the left kidney which is here and here we can see the right kidney. We have also got the duodenum. And we have added in some important blood vessels coming from the aorta we have added in the superior mesenteric artery and here is the inferior vena cava But importantly, here is the hepatic portal vein and here we can see the superior mesenteric vein. We will look at the formation of the portal vein later on. But down here we can see the posterior view. And this again is if you're looking at the duodenum and the pancreas through my posterior abdominal wall, then you can see that we have the "C" shaped duodenum, head of the pancreas, and running posterior to the neck of the pancreas. The neck of the pancreas is been this kind of region. Running posterior to the neck of the pancreas we have these two blood vessels: superior mesenteric artery and superior mesenteric vein.

    02:42 We can actually see the intimate relationship really clearly. If we look here we can see we have what's known as the Uncinate process of the pancreas. And that is lined kind of inferomedially running away from the head.

    02:57 We can see we have the horizontal and the ascending part of the duodenum.

    03:04 Now importantly these two blood vessels, the superior mesenteric blood vessels are lying anterior to the uncinate process and to the horizontal part of the duodenum.

    03:17 These two superior mesenteric blood vessels align anterior to the uncinate process and the horizontal part of the pancreas. But they then run posterior both of them, run posterior to the neck of the duodenum. So if you imagine this is a pancreas here. We got uncinate process and we have the head of the pancreas here. We got the neck, and the body and the tail.

    03:43 And we have got two superior mesenteric vessels, it’s running up in this direction.

    03:48 Anterior to the uncinate process and then posterior to the neck.

    03:51 And that's hopefully what we can see in this diagram. The posterior view shows that well.

    03:56 But we can't see the superior mesenteric vessels here. In the posterior view, we can see them here.

    04:03 Also, we can see the superior mesenteric vein is actually receiving the splenic vein here. So the neck of the pancreas deep to the neck of the pancreas, we have the formation of the hepatic portal vein.

    04:19 Here we have the superior mesenteric vein. Here we have the splenic vein And where these two unite, we then have the hepatic portal vein that's running up towards the liver.

    04:34 If we look at the tail of the pancreas over here, then we can draw what would be the spleen that would be in this position around here not included in this cartoon. And actually running towards the hilum of the spleen we find the splenorenal ligament.

    04:49 So the pancreas within its relations to the other organs and specially those blood vessels.

    About the Lecture

    The lecture Pancreas: in Situ View – Pancreas and Spleen by James Pickering, PhD is from the course Abdomen.

    Included Quiz Questions

    1. Superior mesenteric artery and vein
    2. Inferior mesenteric artery
    3. Inferior mesenteric vein
    4. Splenorenal ligament
    5. Jejunum
    1. Splenorenal ligament
    2. Phrenicocolic ligament
    3. Gastrosplenic ligament
    4. Transverse mesocolon
    5. Greater omentum
    1. Superior mesenteric and splenic
    2. Superior mesenteric and gastric
    3. Inferior mesenteric and gastric
    4. Inferior vena cava and splenic
    5. Gastroduodenal and splenic

    Author of lecture Pancreas: in Situ View – Pancreas and Spleen

     James Pickering, PhD

    James Pickering, PhD

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