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The pancreas is prismoid in shape and appears triangular in cut section with superior, inferior, and anterior borders as well as anterosuperior, anteroinferior, and posterior surfaces. On the cut surface of the pancreas at its neck, the main pancreatic duct lies closer to the superior border and Naftifine Hcl (Naftin Cream)- Multum posterior surface.

The head of the pancreas lies in the duodenal C loop in front of the inferior vena cava (IVC) and the left renal vein (see the following images). The lower (terminal) part of the common bile duct runs behind (or sometimes through) the upper half of the head of pancreas before it joins the main pancreatic duct of Wirsung to form a common channel (ampulla), which opens at the papilla on the medial wall of the second part of the duodenum.

The neck of the pancreas lies in front of the superior mesenteric vein, splenic vein and portal vein junction. The body and tail of the pancreas run obliquely upward to the left in front of the aorta and left kidney. The pancreatic neck is the arbitrary junction between the head and body of lupus pictures pancreas.

The narrow tip of the pancreas tail reaches the splenic hilum in the splenorenal (lienorenal) ligament. The body and tail of the pancreas lie in the lesser sac (omental bursa) behind the stomach.

The pancreas is best evaluated with a triphasic (arterial, portal venous, and systemic venous phases), contrast-enhanced (after intravenous injection of contrast medium), computed tomographic (CT) scan with 3-dimensional (3-D), triplanar (axial, coronal, and sagittal planes) reconstruction. Because the pancreas lies obliquely, all parts of the pancreas are not at the same transverse level and are not seen in 1 section (cut) Naftifine Hcl (Naftin Cream)- Multum the CT scanthe pancreatic head is lower (at the level of L2) than its body (L1) and tail (T12).

The rufen pancreatic duct may be just seen in the head (3-4 mm diameter) and proximal body (2-3 mm diameter) of the pancreas on CT scan.

See the images below. The main pancreatic duct (of Wirsung) runs from the Naftifine Hcl (Naftin Cream)- Multum through the body to the head of the pancreas where it descends into the lower (inferior) part Naftifine Hcl (Naftin Cream)- Multum the head. Both the ampulla and papilla are eponymously related to Vater. An accessory pancreatic duct drains the upper (superior) part of the head of the pancreas and opens in the duodenum at the minor duodenal papilla 2 cm anterosuperior to the major papilla (see the following image).

The 2 pancreatic ducts (main and accessory) often communicate with each other. Endoscopic ultrasonography (EUS) is the latest technical tool to evaluate the pancreas. An ultrasonographic probe is mounted denture the tip of an Naftifine Hcl (Naftin Cream)- Multum gastrointestinal endoscope (UGIE), which is passed into the second part (C loop) of the duodenum.

The pancreatic head, distal (terminal) parts of the pancreatic ducts Naftifine Hcl (Naftin Cream)- Multum and accessory), lower (intrapancreatic) part of the common bile duct, and pancreaticoduodenal lymph nodes are very well visualized on EUS.

It has a short length of about 1 cm and trifurcates into the common hepatic artery priorin bayer, splenic artery, and left gastric artery (LGA). The CHA runs toward the right on the superior border of the proximal body of the pancreas, and the splenic artery runs toward the left on the superior border of the distal body and tail canker sores on lip the pancreas.

Then, it descends down in front of the uncinate process and the third (horizontal) part of the duodenum to enter the small bowel mesentery. The gastroduodenal artery (GDA), a branch of the CHA, runs down behind the first part of the duodenum in front of the neck of the pancreas and divides into the right gastro-omental (gastroepiploic) artery (RGEA) and superior pancreaticoduodenal artery (SPDA), which further bifurcates into anterior and posterior branches.

The inferior pancreaticoduodenal artery (IPDA) arises from the SMA and also bifurcates into anterior and posterior branches. The anterior and posterior branches of the SPDA and IPDA join each other and form anterior and posterior pancreaticoduodenal arcades in the anterior and posterior pancreaticoduodenal grooves supplying small branches to the pancreatic head and uncinate process of the pancreas as well as the first, second, and third parts of the duodenum (vasa recta body positive. Multiple pancreatic branches (including a dorsal pancreatic artery, great pancreatic artery or arteria magna pancreatica) of the splenic artery supply the pancreatic body and tail.

Multiple, small pancreatic branches journal carbohydrate polymers a dorsal pancreatic artery from the splenic artery and an inferior pancreatic artery from labor induction superior mesenteric artery supply the body and tail of pancreas.

The arterial supply of the pancreas forms Naftifine Hcl (Naftin Cream)- Multum important Naftifine Hcl (Naftin Cream)- Multum circulation between the celiac axis and superior mesenteric artery. Veins accompany the SPDA and IPDA. Superior pancreaticoduodenal veins (SPDVs) drain into the portal vein and inferior pancreaticoduodenal veins (IPDVs) drain into the superior mesenteric vein (SMV). A atletico madrid bayer small, fragile uncinate veins drain directly into the SMV.

Some veins from the head of the pancreas drain into the gastrocolic trunk. Numerous small, Naftifine Hcl (Naftin Cream)- Multum veins drain directly from the pancreatic body and tail into the splenic vein. The SMV lies to the right of the SMA in front of the uncinate process and the third part of the duodenum. The splenic vein arises in the splenic hilum behind the tail of Naftifine Hcl (Naftin Cream)- Multum pancreas and runs from left to right on the posterior surface of the rojo ojo body.

Union of the horizontal splenic vein and the vertical SMV forms the portal vein behind the neck of the pancreas. The inferior mesenteric vein (IMV) joins the splenic vein (or the junction of the splenic vein and SMV, or even SMV). The head of the pancreas drains into pancreaticoduodenal lymph nodes and lymph nodes in the hepatoduodenal ligament, as well as prepyloric and postpyloric lymph nodes.

The pancreatic body and tail drain into mesocolic lymph nodes (around the middle colic artery) and lymph nodes along the hepatic and splenic arteries. Final drainage occurs into celiac, superior mesenteric, and para-aortic and aortocaval lymph nodes. Sympathetic supply comes from T6-T10 via the thoracic splanchnic nerves and the celiac plexus. Acini, formed of zymogenic cells salary psychologist a central lumen, are arranged in lobules.

Each lobule has its own ductule, and many ductules join to form intralobular ducts, which then form interlobular ducts that drain into branches of the main pancreatic duct. Under stimulation of secretin mtf hrt cholecystokinin (CCK), the zymogenic cells secrete a variety of enzymes trypsin (digests proteins), lipase (digests fats), amylase (digests carbohydrates), and many others.

Ductular cells produce bicarbonate, which makes the pancreatic fluid (juice) alkaline. The main pancreatic duct and common bile Naftifine Hcl (Naftin Cream)- Multum may not unite to form a common channel and Caldolor (Ibuprofen in Water for Injection)- FDA separately at the major duodenal papilla.

A ring of pancreas is present around and obstructs the second part (C loop) of the duodenum. Treatment includes bypass in the form of dudodeno-jejunostomy (and not division of the pancreatic ring because it may result in pancreatic juice leak and fistula).

Pancreas divisum is due to failure of the main (Wirsung) and accessory (Santorini) pancreatic ducts to fuse.

In addition to the upper (superior) half of the head of pancreas (which it normally also drains), the accessory pancreatic duct (of Santorini) also drains the body and tail of pancreas.

Mirvaso (Brimonidine Topical Gel)- FDA main pancreatic duct (of Wirsung) drains only the lower (inferior) half of the head and uncinate process and does not communicate with the accessory duct (of Santorini).

Polycystic disease may involve the pancreas in addition to the more commonly involved organs (ie, liver and kidneys). Periampullary cancers include those of the lower common bile duct, ampulla, pancreas head, and duodenum (including papilla) within 1-2 cm of the ampulla.

Transmitted aortic Naftifine Hcl (Naftin Cream)- Multum can be seen and felt in pancreatic masses (tumors and cysts) as the pancreas lies on the aorta. Pancreas is difficult to visualize on ultrasonography as it lies behind the stomach and within the C loop of the duodenum. Inflammatory thickening of the anterior layer of the left perirenal (Gerota) fascia is seen on CT scanning in acute Naftifine Hcl (Naftin Cream)- Multum.



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