Pancreas

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Pancreas
Image:Illu pancrease.jpg
Image:Illu pancreas duodenum.jpg
1: Head of pancreas 2: Uncinate process of pancreas 3: Pancreatic notch 4: Body of pancreas 5: Anterior surface of pancreas 6: Inferior surface of pancreas 7: Superior margin of pancreas 8: Anterior margin of pancreas 9: Inferior margin of pancreas 10: Omental tuber 11: Tail of pancreas 12: Duodenum
Gray's	subject #251 1199
Artery	Inferior pancreaticoduodenal artery, Superior pancreaticoduodenal artery
Vein	Pancreaticoduodenal veins
Nerve	Pancreatic plexus, celiac ganglia, vagus[1]
Precursor	pancreatic buds
MeSH	Pancreas
Dorlands/Elsevier	p_02/

The pancreas is an organ in the digestive and endocrine system (of vertebrates^[2]). It is both exocrine (secreting pancreatic juice containing digestive enzymes) and endocrine (producing several important hormones, including insulin, glucagon, and somatostatin).

Contents 1 Anatomy 2 Arteries and veins 3 Function 3.1 Endocrine 3.2 Exocrine 4 Diseases of the pancreas 5 History 6 Diabetes and the Pancreas 7 Pancreas as a food 8 Additional images 9 References

Anatomy

In humans, the pancreas is a 15-25 cm (6-10 inch) elongated organ in the abdomen. One of the organs behind the abdominal cavity, it is located posterior to the stomach and in close association with the duodenum.

It is often described as having three regions: a head, body and tail.

• The pancreatic head abuts the second part of the duodenum.
• The body of the pancreas lies at the level of L2 on the spine.
• The tail of the pancreas extends towards the spleen.

The pancreatic duct (also called the duct of Wirsung^[3]) runs the length of the pancreas and empties into the second part of the duodenum at the ampulla of Vater. The common bile duct usually joins the pancreatic duct at or near this point. Many people also have a small accessory duct, the duct of Santorini, which extends from the main duct more upstream (towards the tail) to the duodenum, joining it more proximal than the ampulla of Vater.^[3]

Arteries and veins

The pancreas is supplied arterially by the pancreaticoduodenal arteries:^[4]

• the superior mesenteric artery provides the inferior pancreaticoduodenal arteries
• the gastroduodenal artery provides the superior pancreaticoduodenal artery

Venous drainage is via the pancreaticoduodenal veins which end up in the portal vein. The splenic vein passes posterior to the pancreas but is said to not drain the pancreas itself. The portal vein is formed by the union of the superior mesenteric vein and splenic vein posterior to the neck of the pancreas. In some people (some books say 40% of people), the inferior mesenteric vein also joins with the splenic vein behind the pancreas (in others it simply joins with the superior mesenteric vein instead).

Function

Under a microscope, when properly stained, it is easy to distinguish two different tissue types in the pancreas.^[5] These regions correspond to the main pancreatic functions:

Appearance	Region	Function
light staining circles (islets of Langerhans)	endocrine pancreas	secretes hormones that regulate blood glucose levels
darker surrounding tissue	exocrine pancreas	produces enzymes that break down digestible foods

Endocrine

There are four main types of cells in the islets of Langerhans. They are relatively difficult to distinguish using standard staining techniques, but they can be classified by their secretion:

Name of cells	Product	% of islet cells	Representative function
beta cells	Insulin and Amylin	50-80%	lower blood sugar
alpha cells	Glucagon	15-20%	raise blood sugar
delta cells	Somatostatin	3-10%	inhibit endocrine pancreas
PP cells	Pancreatic polypeptide	1%	inhibit exocrine pancreas

The islets are a compact collection of endocrine cells arranged in clusters and cords and are crisscrossed by a dense network of capillaries. The capillaries of the islets are lined by layers of endocrine cells in direct contact with vessels, and most endocrine cells are in direct contact with blood vessels, by either cytoplasmic processes or by direct apposition.

The function of the pancreas is to produce important hormones including Insulsin, glucagon and somatostatin

Exocrine

There are two main classes of exocrine pancreatic secretions:

Secretion	Cell producing it	Primary signal
bicarbonate ions	Centroacinar cells	Secretin
digestive enzymes (pancreatic amylase, trypsin, chymotrypsin, etc.)	Basophilic cells	CCK

Diseases of the pancreas

Due to the importance of its enzyme contents, injuring the pancreas is a very dangerous situation. A puncture of the pancreas tends to require careful medical intervention.

• Diabetes mellitus
• Benign tumours
• Pancreatic cancer, including
  • Carcinoma of pancreas
  • Insulinoma
  • Glucagonoma
• Cystic fibrosis
• Exocrine pancreatic insufficiency
• Hemosuccus pancreaticus, or bleeding from or through the pancreatic duct
• Pancreatitis
  • Acute pancreatitis
  • Chronic pancreatitis
  • Hereditary pancreatitis
• Pancreatic pseudocyst

History

The pancreas was discovered by Herophilus (335-280 BC), a Greek anatomist and surgeon. Only a few hundred years later, Ruphos, another Greek anatomist, gave the pancreas its name. The term "pancreas" is derived from the Greek pan, "all", and kreas, "flesh", probably referring to the organ's homogenous appearance.^[6]

Heywood Banks, who performs regularly on the Bob & Tom Show, recorded a song titled "The Pancreas," composed of doggerel verses that rather accurately, if facetiously, decribe the function of the pancreas. The lyrics include "Let's all sing a tribute to the pancreas...hey pancreas, have a nice day!"

Satiric singer "Weird Al" Yankovic has recently produced a song titled "Pancreas." It includes many lyrics about the functions of the organ as well as the names of various chemicals it produces, concluding, "I love my pancreas!" The song can be found on his 2006 album "Straight Outta Lynwood."

Diabetes and the Pancreas

A new discovery might have important implications for treatment of diabetes. Researchers at the Toronto Hospital for Sick Children injected capsaicin into NOD mice (Non-obese diabetic mice, a strain that is genetically predisposed to develop the equivalent of type 1 diabetes) to kill the pancreatic sensory nerves. This treatment reduced the development of diabetes in these mice by 80%, suggesting a link between neuropeptides and the development of diabetes. When the researchers injected the pancreas of the diabetic mice with sensory neuropeptide (sP), they were cured of the diabetes for as long as 4 months. Also, insulin resistance (characteristic of type 2 diabetes) was reduced. These research results are in the process of being confirmed, and their applicability in humans will have to be established in the future. Any treatment that could result from this research is probably years away.

Pancreas as a food

Pancreases (specifically calf and lamb pancreases) are used in some meals often going by the name stomach sweetbreads.^[2]

Additional images

Accessory digestive system.	Digestive organs.	The celiac artery and its branches; the stomach has been raised and the peritoneum removed.	Lymphatics of stomach, etc. The stomach has been turned upward.
Transverse section through the middle of the first lumbar vertebra, showing the relations of the pancreas.	The duodenum and pancreas.	The pancreatic duct.	Pancreas of a human embryo of five weeks.
Pancreas of a human embryo at end of sixth week.	Front of abdomen, showing surface markings for duodenum, pancreas, and kidneys.

References

1. ^ Physiology at MCG 6/6ch2/s6ch2_30
2. ^ ^{a b} New Standard Encyclopedia, 1988. Volume P Page 68
3. ^ ^{a b} Cutler, Anne G., et al., eds. Stedman's Medical Dictionary. Baltimore: The William and Wilkins Company, 1976 ed.
4. ^ Norman/Georgetown pancreas
5. ^ Histology at BU 10404loa
6. ^ Harper, Douglas. Pancreas. Online Etymology Dictionary. Retrieved on April 4, 2007.

af:Pankreas

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