Dr. Mujahid Khan
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It is a “C” shaped tube
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About 10 inches (25 cm) long
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It joins the stomach to the jejunum
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It receives openings of bile and pancreatic
ducts
Curves around the head of the pancreas
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First inch of duodenum resembles stomach as
its anterior and posterior surfaces are also
covered with peritoneum
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Lesser omentum attached to its upper border
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Greater omentum attached to its lower border
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Remainder of the duodenum is retroperitoneal,
only partially covered by peritoneum
Is divided into four parts for the purpose of
description
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It is 2 inches (5 cm) long and begins at pylorus
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Situated in the epigastric and umbilical regions
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Lies on the transpyloric plane
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Anteriorly: Quadrate lobe of the liver and gall
bladder
Posteriorly: The lesser sac, gastroduodenal
artery, bile duct, portal vein and IVC
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Superiorly: The entrance into the lesser sac
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Inferiorly: Head of the pancreas
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Is 3 inches (8 cm) long and runs vertically
downward in front of the hilum of the right
kidney
Halfway down its medial border, the bile duct
and main pancreatic duct pierce the duodenal
wall by major duodenal papilla
The accessory pancreatic duct if present, opens
a little higher up on the minor duodenal papilla
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Anteriorly: The fundus of gall bladder, right
lobe of liver, and the transverse colon
Posteriorly: Hilum of the right kidney and the
right ureter
Laterally: Ascending colon, right colic flexure,
and the right lobe of the liver
Medially: Head of the pancreas, bile duct, and
the main pancreatic duct
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Is 3 inches (8 cm) long
Runs horizontally to the left on the subcostal
plane
Passing in front of the vertebral column
Following the lower margin of the head of the
pancreas
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Anteriorly: The root of mesentery of small
intestine, superior mesenteric vessels
Posteriorly: The right ureter, right psoas
muscle, IVC, and the aorta
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Superiorly: Head of the pancreas
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Inferiorly: Coils of jejunum
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Is 2 inches (5 cm) long
Runs upward and to the left of the
duodenojejunal flexure
The flexure is held in position by a peritoneal
fold, ligamentum treitz
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Anteriorly: The beginning of the root of the
mesentery and coils of jejunum
Posteriorly: The left margin of aorta, and the
medial border of the left psoas muscle
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Is thick and smooth in the first part
In the remainder parts is thrown into
numerous circular folds called plicae circulares
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The upper half is supplied by superior
pancreaticoduodenal artery, a branch of
gastroduodenal artery
The lower half is supplied by the inferior
pancreaticoduodenal artery, a branch of the
superior mesenteric artery
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The pancreas is both an exocrine and an
endocrine gland
Produces a secretion that hydrolyzes the
carbohydrates, proteins and fats
The endocrine portion of the gland is islets of
langerhans produces insulin and glucagon
hormones
These hormones play a key role in
carbohydrate metabolism
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It is an elongated structure
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Lies in the epigastrium and left upper quadrant
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It is soft and lobulated, situated on the
posterior abdominal wall behind the
peritoneum
It is divided into head, neck, body and tail
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Head: Is a disc shaped and lies within the
concavity of the duodenum, has a process
behind the superior mesenteric vessels called
uncinate process
Neck: Is the constricted portion, connects the
head to the body, lies in front of the origin of
the superior mesenteric artery from the aorta
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Body: Runs upward and to the left across the
midline and is somewhat triangular in cross
section
Tail: Passes forward in the splenicorenal
ligament and comes in contact with the hilum
of the spleen
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Anteriorly: Transverse colon and the
attachment of the transverse mesocolon, the
lesser sac and the stomach
Posteriorly: Bile duct, the portal and splenic
veins, IVC, the aorta, the origin of superior
mesenteric artery, the left suprarenal gland, the
left kidney, and the hilum of the spleen
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The main duct of the pancreas begins in the tail
Runs the length of the gland, receiving
numerous tributaries
Opens into the second part of the duodenum
with the bile duct on the major duodenal
papilla
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Sometimes the main duct drains separately into
the duodenum
The accessory duct, if present, drains the upper
part of the head
Opens a little above the main duct on the
minor duodenal papilla
The accessory duct frequently communicates
with the main duct
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Arteries: The superior and inferior
pancreaticoduodenal arteries
Veins: The corresponding veins drain into the
portal vein