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.
The small intestine except the duodenum,
which is positioned here has been removed.
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.
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.
The tail of the pancreas passes
to the spleen with the splenorenal ligament
that contains the splenic artery and the splenic vein.
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.
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.
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.
We can see we have the horizontal and
the ascending part of the duodenum.
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.
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.
And we have got two superior mesenteric vessels,
it’s running up in this direction.
Anterior to the uncinate process and then posterior to the neck.
And that's hopefully what we can see in this diagram.
The posterior view shows that well.
But we can't see the superior mesenteric vessels here.
In the posterior view, we can see them here.
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.
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.
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.
So the pancreas within its
relations to the other organs
and specially those blood vessels.