ABSTRACT
The internal anatomy of the pancreas and its relationship to the duodenum and bile ducts is illustrated in Figure 19.1 (p. 322). The pancreas consists of a head, uncinate process, neck, body and tail. The head and uncinate process are located within, and are intimately associated with, the concavity of the duodenum. The body and tail pass upwards and backwards covered with the peritoneum of the posterior wall of the lesser sac, with the tail terminating at the splenic hilum. The anterior surface of the pancreas is for the most part in contact, through the lesser sac, with the posterior aspect of the stomach. The posterior surface of the pancreas is associated with the inferior vena cava, aorta, portal vein, splenic vein, the left renal vessels and the left kidney. The portal vein is formed by the confluence of the superior mesenteric vein and splenic vein behind the neck of the pancreas. The splenic artery has a wavy course along the upper border and the splenic vein lies behind the body and tail of the pancreas. The superior mesenteric artery and vein pass over the anterior aspect of the uncinate process and lie posterior to the neck of the pancreas. The neck of the pancreas lies in front of the vertebral bodies and is at risk of damage during compression-type injuries to the abdomen. An accessory or ‘replaced’ right hepatic artery arising from the superior mesenteric artery may run upwards behind the head of the pancreas.
