THE PANCREAS. 1069 



surface of the head is bound by loose tissue to and rests upon the inferior vena 

 cava and right crus of diaphragm, coeliac plexus, left renal vein, and right renal 

 vessels : the descending duodenum intervenes between it and the right kidney. 

 Near its lower end it is crossed in front by the transverse colon and transverse 

 mesocolon. The superior and inferior pancreatico-duodenal vessels are in front 

 of the head. 



The neck is about one inch long, passing upward and forward to the left : it 

 is bounded above by the first part of the duodenum and below by the end of the 

 ascending portion. The stomach, if distended, touches this portion by the poste- 

 rior surface of the pylorus. Behind it is the junction of the superior mesenteric 

 vein with the vena porta? (Fig. 681). To the right it is grooved by the gastro- 

 duodenal and superior pancreatico-duodenal arteries. 



The body and tail constitute the prismatic portion presenting three surfaces 

 and three borders: '!/if. ,rir. posterior, and inferior surfaces; superior and two 

 lor borders. Some regard the surfaces as posterior, antero-superior, and 

 antero-inferior. making an anterior border more distinct. This part of the pan- 

 creas passes from the right to the left and is moulded to different structures, 

 following the example of the liver. Its anterior surface is fitted to the convexity 

 of the filled stomach : its posterior surface is more flat except where it covers the 

 left kidney : the tail passes upward and backward to the spleen. The anterior 

 surface is concave, looks upward and forward ; the posterior surface of the stomach 

 lies upon it. separated by the bursa omentalis, or two layers of the lesser sac. 

 Perforating ulcers of the stomach can reach the pancreas and result in fusion of 

 these two organs, or in hemorrhage from the splenic vessels. 



The post:ri>~>r surface (Figs. 680 and 681) corresponds internally to the aorta 

 and left crus of the diaphragm and the origin of the superior mesenteric artery. 

 It crosses the second or third lumbar vertebra. Near the upper edge are two fur- 

 r-.iws one for the somewhat tortuous splenic artery and a straight one for the 

 splenic vein. The surface shows a shallow furrow for the splenic vein, which 

 ascends from the middle of the lower edge toward the left to the upper edge. 

 This edge carries a furrow from the middle along the left half, in which the 

 splenic artery takes part of its course. The splenic vein in its outer half runs 

 above the edge to reach the hilus of the spleen. To the left is the left kidney 

 and its vessels, and sometimes the left suprarenal capsule. The relations to the 

 left kidney show two types : one is seen in the His models and Fig. 636. where 

 the pancreas runs directly over the hilus and centre of the kidney, exposing the 

 suprarenal capsule, and a considerable part of the anterior kidney surface above, 

 the tail touching the lower part of the spleen. 



The other type is seen in Fig. 634. Here the pancreas is higher, and crosses 

 the upper part of the kidney, leaving exposed above its edge the whole or only a 

 part of the left suprarenal capsule. The tail touches the same part of the spleen 

 in each case, showing it is also elevated with the pancreas. (Compare Figs. 

 634 and 679.) 



The *nrfa?e is narrow, only 1 to - cm. broad, and shows, in the organ 



hardened in situ, internally a cavity and laterally a convexity, each directed 

 downward. It rests by the concavity on the duodeno-jejunal flexure, and often 

 on some coils of the jejunum, and to the left on the transverse colon. 



The fup-.-rior border of the body on the right is prominent, blunt, and flat ; 

 laterally, near the tail, it is narrower and sharper. The inner blunt elevation is 

 covered by the lesser omentum. and fits into and behind the lesser curvature of 

 the stomach : it is the tuber omentale of the pancreas. Between it and the tuber 

 omentale of the liver is the lesser sac. This border is related above to the coeliac 

 axi.s and solar plexus, and to two of the branches of the former, the hepatic 

 artery passing to the right, the splenic to the left. 



The inferior or anterior border is the dividing line for the two layers of the 

 transverse mesocolon. The upper layer passes up over the anterior surface and 

 here constitutes the posterior wall of the lesser sac. The lower layer passes down 



