82 



PANCREAS. 



fully dissected away, it presents eminences for instance, the longitudinal furrow occupied 

 and depressions corresponding to them, as, by the splenic vein, and the deep groove in 



Fig. 51. 



Human Pancreas, sliou-n in situ by throwing up the 

 suliject in which the curvature of the head of the 

 ticularly well shown. 



which the superior mesenteric artery and the 

 vena portae are received. 



In front it is in relation with the posterior 

 surface of the stomach, which rests on it 

 when empty (tanquam pulvinar, Scemm.), and 

 moves freely upon it; but when this organ is 

 distended with food, it recedes from it, and 

 its lesser curvature comes into more immediate 

 relation with the gland. In cases in which 

 the stomach is situated lower down than 

 usual, as in emaciated individuals, where a 

 great part of the small intestine occupies the 

 cavity of the pelvis, the pancreas conies into 

 relation in front either with the liver, or with 

 the anterior wall of the abdomen, from which 

 the gastro-hepatic omentmn alone separates 

 it, and through which it may be easily felt. 

 This disturbance of the normal relations al- 

 ways exists, according to Cruveilhier, when- 

 ever the vertebral column can be felt im- 

 mediately behind the walls of the abdomen. 

 The pancreas is also in relation, in front, with 

 the angle formed by the ascending and trans- 

 verse colon and with the commencement of 

 the duodenum. 



The upper border is in relation with the 

 splenic artery, for the reception of which it 

 is grooved, and which often runs in a canal 

 formed in the substance of the gland through 



stomach. This dftiwing was taken from a young 

 pancreas, following that of the duodenum, was par- 

 its entire length ; it is in relation also with 

 the Spigelian lobe of the liver, with the first 

 portion of the duodenum, and the cceliac axis. 



The lower border is bounded by the inferior 

 horizontal portion of the duodenum, from 

 which it is separated, near the middle line, by 

 the superior mesenteric vein and artery, which 

 notch it, and which also separate it from its 

 reflected portion or head. 



The right extremity is engaged in the duo- 

 denal fold in the manner described, and is in 

 relation with the ductus choledochus. From 

 the intimacy of its attachments to the duode- 

 num, it always accompanies this intestine in 

 its displacements, so that when the duodenum 

 is situated lower down than usual, which 

 happens in displacements of the stomach 

 downwards, the head of the pancreas is al- 

 ways removed in the same direction. 



The left extremity is in relation with the 

 left kidney, and with the spleen upon which 

 it is sometimes flattened and blunted, and 

 sometimes slightly enlarged, and to which it 

 is attached by the intervention of the splenic 

 veins, which send many branches into its sub- 

 stance : sometimes it does not extend quite 

 so far as the spleen by half an inch or an 

 inch. 



Shape. From its elongated form, the pan- 



