THE PANCREAS 441 



holding 8 to 12 drams, and is held in place by areolar tissue 

 and the peritoneum. The fundus looks downward, forward, 

 and to the right; the body and neck upward, backward, and 

 to the left. Its relations are as follows: Above, liver; below, 

 ascending duodenum, pyloric end of stomach, hepatic flexure 

 of colon; in front, abdominal wall (ninth or tenth costal cartil- 

 ages). The hepatic duct is formed by the junction at an obtuse 

 angle of a branch from each lobe, and runs downward and to 

 the right for nearly 2 inches, and joins the cystic duct to form 

 the common bile duct. The cystic duct is 1^ inches long, and 

 descends toward the left and joins the above as described. 

 The common bile duct is nearly 3 inches long and 3 lines in 

 diameter. It runs along the right border of the lesser omentum 

 behind the first part of the duodenum, and between the pan- 

 creas and descending duodenum, then to the right of the 

 pancreatic duct, with which it opens by a common orifice 

 (ampulla of Vater) at the summit of a papilla just below the 

 middle of the inner wall of the second portion of the duodenum. 

 The cystic artery and vein comprise the blood supply. 



THE PANCREAS 



The pancreas is a compound racemose gland, of a reddish- 

 white color. Situated at the back of the epigastrium and left 

 hypochondrium ; connected to the posterior abdominal wall 

 by connected tissue and lies retroperitoneal. It is 5 to 6 inches 

 long; its breadth is 1^ inches; its thickness \ to 1 inch, being 

 greater at its right extremity and upper border. The pancreas 

 is divided into a head, a neck, a body, and a tail. 



The Relations of the Pancreas. The head is flattened from 

 before backward, and is lodged within the curve of the duo- 

 denum. Above, is the first portion of the duodenum and the 

 gastroduodenal artery and vein; below, it overlaps the third 

 portion of the duodenum; in front, in the groove between 

 the 'right lateral and lower borders, are the anastomosing pan- 

 creaticoduodenal arteries, the transverse colon and inferior 

 layer of the transverse mesocolon, and coils of intestines. 

 The uncinate process has passing over it the superior mesenteric 

 vessels, the vein lying to the right of the artery. Behind, 

 is the inferior vena' cava, the renal vein and artery, the right 



