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Blood Supply and Innervation of the Pancreas

The pancreas is a unique abdominal organ in that it is classified as both endocrine and exocrine in function. This article covers an overview of its gross anatomy, its blood supply and innervation and concludes with a summary of the most important highlights.

Anatomy

The pancreas is situated posterior to the stomach and is supported by the floor of the lesser sac or omental bursa. It is a retroperitoneal visceral tissue mass, save its tail which communicates with the right aspect of the spleen.

Pancreas - ventral view

Macroscopically, it is theoretically divided into four main parts running from the midline to the left side of the body and includes the: 

  • head
  • neck
  • body
  • tail, in that order

The head is partially encompassed by the C-shaped curvature of the proximal part of the duodenum and its uncinate process stabilizes it because it is wedged between the duodenum and the superior mesenteric vessels, which lie slightly anterior to this tissue convexity. The neck is bordered posteriorly by the superior mesenteric vessels, as the pancreas veers anteriorly towards its tail and is situated just inferior to the pylorus of the stomach. The body of the pancreas points cranially and stretches over the duodenojejunal flexure as well as the superior aspect of the left kidney. Lastly and most laterally, the tail of the pancreas forms its apex at the hilum of the spleen within the splenorenal ligament.

Recommended video: Pancreas in situ
Pancreas in situ seen from the anterior view.

Histology

Histologically, the pancreas contains many different cells that are responsible for the multiple metabolic functions that the pancreas must perform. These digestive mechanisms are essential for the breakdown and absorption of nutrients acquired from the dietary intake of food and without them healthy sustenance would be almost impossible. The exocrine pancreas is comprised of the acinar and pancreatic ductal cells. The acinar cells secrete various substances which process proteins, starches and fats. The pancreatic ductal cells secrete bicarbonate ion in a fluid which helps neutralize the acidic chyme that is dumped by the stomach into the duodenum.

Pancreatic acinar cells - histological slide

The endocrine pancreas is made up of the islets of langerhans which secrete various hormones such as insulin, glucagon and somatostatin. Pancreatic secretion is governed by both the vagus nerve (CN X) and the hormones secretin and cholecystokinin.

Islets of Langerhans - histological slide

Arterial Supply

The main vascular supply of the pancreas is governed by the splenic artery and its subsequent branches, which stem from the celiac trunk of the aorta at the level of the twelfth thoracic vertebra.

Splenic artery - ventral view

It also receives blood from the superior mesenteric artery, the gastroduodenal artery and also the superior and inferior pancreaticoduodenal arteries.

Venous Drainage

The venous drainage of the pancreas occurs mainly by the splenic vein, which merges with the superior mesenteric vein and enters the liver as the portal vein. Some branches however communicate directly with the superior mesenteric vein and thus a loop of venous drainage utilising both sets of venous plexuses occurs.

Splenic vein - ventral view

Lymphatic Drainage

The lymphatic drainage of the pancreas allows the lymphatic fluid that it produces to run in the tiny networks that sit on the blood vessels supplying the area and collect in the pancreaticosplenic nodes which are found sitting along the splenic artery. These drain into the celiac lymphatic plexus and from there either indirectly into the thoracic duct via the cisterna chyli or directly into it depending on the presence of the sac.

Celiac lymph nodes - ventral view

Innervation

The nervous supply of the pancreas is comprised of three different nerve bundles including the vagus nerve (CN X), the thoracic splanchnic nerves fibers from the superior mesenteric and celiac plexuses.

Vagus nerve - lateral-left view

Summary

The pancreas is a unique abdominal organ in that it is classified as both endocrine and exocrine in function. It is situated posterior to the stomach and is supported by the floor of the lesser sac or omental bursa. It is a retroperitoneal visceral tissue mass, save its tail which communicates with the right aspect of the spleen.

The main vascular supply of the pancreas is governed by the splenic artery and its subsequent branches, which stem from the celiac trunk. It also receives blood from the superior mesenteric artery, the gastroduodenal artery and also the superior and inferior pancreaticoduodenal arteries.

The venous drainage of the pancreas occurs mainly by the splenic vein.

The lymphatic drainage of the pancreas is into the pancreaticosplenic nodes which are found sitting along the splenic artery. These drain into the celiac lymphatic plexus.

The nervous supply of the pancreas is comprised of three different nerve bundles including the vagus nerve (CN X), the thoracic splanchnic nerves fibers from the superior mesenteric and celiac plexuses.

Blood Supply and Innervation of the Pancreas - want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

Sign up for your free Kenhub account today and join over 931,206 successful anatomy students.

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

Show references

References:

  • Frank H. Netter, MD: Atlas of Human Anatomy, Fifth Edition, Saunders - Elsevier, Chapter Abdomen, Subchapter 28 Viscera (Accessory Organs), Guide: Liver, Page 150 and Subchapter 29 Visceral Vasculature, Guide Abdomen: Visceral Vasculature, Pages 153 to 157 and Subchapter 30, Innervation, Page 159.
  • John T. Hansen: Netter’s Clinical Anatomy, Second Edition, Saunders - Elsevier, Chapter 4 Abdomen, Pancreas, Pages 150.
  • Vinay Kumar Kapoor, MBBS, MS, FRCSEd, FACS, FACG, FICS, FAMS: Pancreas Anatomy. Medscape. March 22, 2013.

Author:

  • Dr. Alexandra Sieroslawska

Illustrators:

  • Pancreas - ventral view - Esther Gollan
  • Pancreatic acinar cells - histological slide - Smart In Media
  • Islets of Langerhans - histological slide - Smart In Media
  • Splenic artery - ventral view - Esther Gollan
  • Splenic vein - ventral view - Begoña Rodriguez
  • Celiac lymph nodes - ventral view - Esther Gollan
  • Vagus nerve - lateral-left view - Paul Kim
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

Related diagrams and images

Arteries of the pancreas, the duodenum and the spleen

Lymphatics of the pancreas, the duodenum and the spleen

Pancreas in situ

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