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Topographic Anatomy · Topographic Anatomy of the Abdomen

Pancreas

Pancreas

The pancreas (pancreas) is a retroperitoneal organ located in the upper abdomen, closely associated with the duodenum, liver, and stomach. It has an elongated shape, divided into a head, body, and tail, with its ducts ensuring the outflow of secretion.

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LocationRetroperitoneal, posterior to the stomach in the upper floor of the abdomen
Parts of the organHead, neck, body, and tail
Normal length16–17 cm (ranging from 14 to 23 cm)
Accessory ductPresent in 94% of cases
4 min readFor medical studentsUpdated 09/24/2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Topography and Skeletotopy

The organ is located retroperitoneally in the upper floor of the abdominal cavity, posterior to the stomach. Its projection onto the anterior abdominal wall is defined by a horizontal line connecting the ends of the VII–VIII ribs, or by a line passing midway between the xiphoid process and the umbilicus (corresponding to the first lumbar vertebra).

Anatomically and functionally, the gland is closely connected with the duodenum, as well as with the liver and stomach.

Morphology and dimensions

The shape of the gland is variable — elongated, arcuate, mallet-shaped, or angular, though the elongated shape is most common. Four main parts are distinguished in its structure:

  1. Head (caput) — a thickened part of irregular quadrilateral shape, embracing the inner curve of the duodenum. A uncinate process (processus uncinatus) may extend downwards and to the left from its lower margin.
  2. Neck (collum) — a small transitional area between the head and the body.
  3. Body (corpus) — the largest middle part of the organ, having the shape of a triangular prism with anterior, posterior, and inferior surfaces. An omental tuberosity (tuber omentale pancreatis) is noticeable on the right part of the anterior surface.
  4. Tail (cauda) — a flattened end of conical or pyriform shape, which is more mobile compared to the rest of the gland.

Normal dimensions of the organ are: length 16–17 cm; width of the head about 5 cm, body — 3.5 cm; thickness of the head reaches 1.9–3.4 cm, and the tail — 0.6–2 cm.

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Duct system

The secretion of the gland is collected by small lobular ducts that empty into the main and accessory ducts:

  • Main pancreatic duct (ductus pancreaticus) extends from the tail to the head. Its length averages 20 cm, and its diameter increases closer to the head up to 3.5 mm. It opens at the major duodenal papilla, most commonly merging with the common bile duct.
  • Accessory duct (ductus pancreaticus accessorius) is found in 94% of observations. It lies in the upper-anterior parts of the head, connects with the main duct, and usually opens independently at the minor duodenal papilla.

Blood supply and innervation

The blood supply to the gland has specific features depending on the region:

  • Head receives blood from the anterior and posterior arterial arcades, which are formed by the superior pancreatoduodenal arteries (from the a. gastroduodenalis system) and inferior ones (from the a. mesenterica superior).
  • Body and tail are supplied by branches of the splenic artery (rr. pancreatici).

Venous outflow is directed straight into the portal vein and its main tributaries (vv. lienalis et mesenterica superior).

Innervation is carried out by branches of the celiac, hepatic, superior mesenteric, splenic, and left renal plexuses. The intertwining of nerves forms a powerful reflexogenic zone, irritation of which can provoke a shock state.

Briefly: answers to topical questions

Which lymph nodes drain lymph from the pancreas?

Lymph drainage from the pancreas is directed to the first- and second-stage lymph nodes.

  • 1st-stage nodes — pyloric, pancreatoduodenal, superior and inferior pancreatic, splenic.
  • For the region of the splenic hilum, body, and tail of the pancreas, subpyloric and superior mesenteric nodes are also indicated as 1st-order nodes.
  • 2nd-stage nodes — pre-aortic, lateral caval, post-caval; celiac lymph nodes are also indicated as the main regional second-order nodes for the pancreas.

Which organs are directly adjacent to the pancreas anteriorly and posteriorly?

The pancreas is located retroperitoneally, posterior to the stomach.

  • Anteriorly — the stomach; the transverse colon is also anterior to the pancreas, while posterior to the transverse colon are the duodenum, pancreas, and left kidney, separated by the mesentery and parietal peritoneum.
  • Posteriorly — the abdominal aorta; on the posterior surface of the pancreatic body, there is a depression for the splenic vein.
  • Pancreatic head occupies the inner curve of the duodenum; the superior, descending, and inferior parts of the duodenum are adjacent to the head.
How to memorize

Parts of the gland in order from duodenum to spleen: Head, Neck, Body, Tail (HNBT — "Happy Nurse Brings Tea").

Class and exam questions

What is the skeletotopy of the pancreas?

The organ is projected onto the anterior abdominal wall along a horizontal line connecting the ends of the VII–VIII ribs, or along a line midway between the xiphoid process and the umbilicus, corresponding to the 1st lumbar vertebra.

How are the arterial arcades of the pancreatic head formed?

The anterior and posterior arterial arcades of the head are formed by the union of the superior pancreatoduodenal arteries (branches of the gastroduodenal artery) and the inferior pancreatoduodenal arteries (from the superior mesenteric artery).

What is the clinical significance of the pancreatic nerve plexuses?

The nerve plexuses of the head and body of the gland constitute a powerful reflexogenic zone, strong irritation of which can lead to the development of a shock state.

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What else to study on this topic

  • Variants of the main pancreatic duct opening and the sphincter apparatus of the ampulla
  • Ligamentous apparatus of the organ: gastropancreatic, gastroduodenopancreatic (pyloric-pancreatic), and splenopancreatic ligaments
  • Anatomy of the 1st and 2nd stage lymph nodes of lymph drainage
  • Structure of the uncinate process (processus uncinatus) and the omental tuberosity
  • Topographo-anatomic features of the mobility of the head and tail of the gland

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The entire section "Topographic Anatomy of the Abdomen"

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