1206 THE DIGESTIVE SYSTEM. 



Corpus Pancreatis. The body is of a prismatic form, largest where it lies in 

 front of the left kidney, and usually somewhat tapering towards the tail (Fig. 948). 

 Beginning at the termination of the neck, it runs backwards and to the left across the 

 front of the left kidney, beyond which its extremity or tail comes in contact with the 

 spleen. When hardened in situ it presents three surfaces anterior, inferior, and 

 posterior all of which are of nearly equal width (namely, about 1 J inches : 31 mm.). 



Facies Anterior. The anterior surface is widest towards the left end ; it looks 

 upwards and forwards (Fig. 947), and forms a considerable portion of the stomach-bed. 

 This surface is completely covered by peritoneum, derived from the posterior wall of the 

 bursa omentalis, which latter separates the pancreas from the posterior surface of the 

 stomach. Towards its right extremity it usually presents an elevation or prominence 

 where the body joins the neck. This projects against the back of the lesser omen turn 

 when the stomach is distended, and is consequently known as the tuber omentale. 



Facies Inferior. The inferior surface, which, like the anterior, is, as a rule, widest 

 towards its left end, looks downwards and slightly forwards. It is completely covered 

 by peritoneum, continuous with that forming the posterior layer of the transverse meso- 

 colon (Fig. 947). It lies in contact with the duodeno-jejunal flexure towards its right 

 end, with the left flexure of the colon near its left end, and with a mass of small intestine 

 (jejunum, which is always found packed in beneath it) in the rest of its extent. 



Facies Posterior. The posterior surface looks directly backwards, and is entirely 

 destitute of peritoneum. It is connected by areolar tissue to the posterior abdominal 

 wall with the organs lying upon it. From right to left these are : the aorta with the origin 

 of the superior mesenteric artery, the left renal vessels, the left supra-renal gland, and the 

 left kidney. In addition, the splenic artery runs its tortuous course to the left along 

 the superior border of the pancreas, whilst the splenic vein runs, behind the gland, at 

 a lower level than the artery. 



The three surfaces of the body of the pancreas are separated by three borders. The 

 margo anterior is the most prominent, and gives attachment to the transverse mesocolon 

 (Fig. 947). It is, as it were, squeezed forward, by the pressure of the stomach above and 

 the small intestine below, into the interval between these two sets of viscera, thus follow- 

 ing the line of least resistance (Cunningham). Towards the neck this border is no 

 longer prominent, but becomes rounded off, so that here the superior and inferior surfaces 

 are confluent. 



The coeliac artery projects over the margo superior, and sends its hepatic branch to the 

 right, resting upon it, whilst the splenic artery runs to the left along it (Fig. 947). The 

 margo inferior calls for no special description. 



Cauda Pancreatis. The tail of the pancreas is the somewhat pointed left end of 

 the body, which is in contact with the inferior portion of the gastric surface of the spleen. 

 It usually presents an abrupt, blunt ending, in which case it is related to the spleen in the 

 manner just described; or it may be elongated .and narrow, when it bends backwards 

 around the lateral aspect of the kidney, and beneath the base of the spleen. In either 

 case it is in near relation below with the left flexure of the colon (Fig. 947). 



Peritoneal Relations of the Pancreas. The posterior surface of the pancreas 

 is entirely free from peritoneum. The other surfaces derive their peritoneal covering 

 from the prolongation of the two layers of the transverse mesocolon, which is attached 

 to the anterior border of the gland, from the tail to the neck. At this border the two 

 layers separate (Fig. 914, p. 1160), the anterior derived from the bursa omentalis 

 passing backwards and upwards over the anterior surface ; the posterior derived 

 from the large sac turning downwards and backwards along the inferior surface. 



As the transverse mesocolon is followed to the right it is, as a rule, found to terminate near 

 the neck of the pancreas (Fig. 947). Beyond this, the posterior surface of the colon is generally 

 free from peritoneum, and is connected by areolar tissue to the anterior aspect of the head of the 

 gland. Below the level of the colon the head is covered by the continuation downwards of the 

 peritoneum from the inferior surface of that gut. Often, however, the transverse mesocolon is 

 continued to the right as far as the right colic flexure, and the anterior surface of the head is 

 then completely covered by peritoneum. 



Ducts of the Pancreas. Almost invariably two ducts are found in the interior 

 of the pancreas the ductus pancreaticus [Wirsungi] or pancreatic duct proper and 

 the ductus pancreaticus accessorius [Santorini], accessory pancreatic duct (O.T. duct 

 of Santorini). 



The pancreatic duct [Wirsungi] begins near the tip of the tail by the union of 

 small ducts from the lobules forming that part of the organ. From there it pursues 



