Pancreas: anatomy, function and treatment

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Located in the upper abdomen between the spleen and the duodenum (the highest section of the small intestine just behind the stomach), the pancreas is an important digestive and endocrine organ. Fulfilling this double function, it consists of two types of glands: exocrine and endocrine. The former produce enzymes for digestion, while the latter carry hormones into the bloodstream. It has an elongated shape that tapers from wider to narrower when moved from right to left, resembling a single quotation mark rotated 90 degrees from the left.

Diseases or disorders of the pancreas can be dangerous, devastating, and require serious medical attention. The most common are pancreatitis (inflammation of the organ), pancreatic cancer, and perforation (in which digestive enzymes cause holes in the surface). In particular, type I and type II diabetes can severely affect pancreatic function, affecting insulin production .

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Anatomy

Composition

The pancreas is an elongated organ that is about 15 centimeters (cm) long and tapered. Anatomically, it is divided into four parts :

  • Head: The head of the pancreas, as its name suggests, is the widest part of the organ. It joins the descending and horizontal part of the duodenum, which is C-shaped. From the left down, on the lateral border, the hook-shaped process protrudes, a small part of the organ that connects to the superior mesenteric vein. This section also contains the bile duct, which plays a role in digestion.
  • Neck: Usually about 2 cm in size, the neck of the pancreas connects the head to the body.
  • Body: Expanding after the neck, the body of the pancreas crosses the center of the body, with the front part enclosed by the peritoneum (a dense layer of tissue that surrounds the abdominal cavity) and the back part touching the aorta , the superior mesenteric . artery , and the left kidney, among other anatomical structures.
  • Tail: The tapered end of the pancreas is a tail that lies directly in front of the left kidney. This is where the main duct of the pancreas is located, which secretes insulin and digestive enzymes.

It is noteworthy that the pancreas is made up of two different types of cells, which largely determine its function. About 80% of the organ is made up of exocrine pancreatic tissue, which is made up of specialized cells called "pancreatic acini." They produce enzymes that bind to bile and serve for digestion. Most of the remaining cells are endocrine cells and form parts of the pancreas called "islets of Langerhans"; They are associated with the production of hormones that can enter the bloodstream directly.

It is also important to understand the pancreatic duct system, as they are essential to its function. The main duct of the pancreas (also known as the "Wirsung duct") runs the length of the organ, from head to tail, which connects to the bile duct in the head, forming the ampulla of Vater, which opens towards the duodenum. The movement of bile through this duct is regulated by a smooth muscle structure called the sphincter of Oddi , which prevents material from the intestines from reaching the pancreas. Other ducts also have sphincters that control the release of hormones and enzymes.

Location

The pancreas is located in the upper part of the abdomen, at the level of the L1 and L2 vertebrae of the lumbar area, and when moving along the posterior abdominal wall, it tilts slightly. On the right is the duodenum, which bends around the head of the pancreas, and on the left is the spleen. It is located in front of the left kidney, the left adrenal gland (which produces hormones such as adrenaline), and the aorta, and just below and behind the stomach. The pancreas is what is called the "retroperitoneal" organ, that is, the peritoneum, the abdominal membrane, lies in front of it.

Anatomical variations

Most of the changes in the anatomy of the pancreas are related to the duct system. It is important to note that these cases are relatively rare, as approximately 95% of people do not have any options. The most commonly observed of these is a condition called "division of the pancreas" in which there is abnormal fusion or no fusion. The pancreatic ducts is a case that is estimated to affect 3% to 14% of the general population. Also, in about 3-5% of cases, pancreatic tissue is mistakenly found in the stomach or small intestine, although this rarely leads to health problems .

On much rarer occasions, doctors have looked at several other options. These include ansa pancreatica, in which the main duct of the pancreas and the accessory duct of the pancreas are mistakenly connected, as well as the annular pancreas, which has a different shape, and a ring of pancreatic tissue surrounds the duodenum . Additionally, the pancreas can be prone to "duplication abnormalities" in which the main duct is duplicated, which can lead to health problems.

Function

The uniqueness of the pancreas lies in the fact that it performs exocrine and endocrine functions. The former means that this organ releases important digestive enzymes to other organs and as such synthesizes and delivers zymogen, an inactivated enzyme, to the duodenum of the small intestine. This substance is activated when it leaves the pancreas. proteolytic enzymes and is converted into several different active digestive substances , including active peptidases, amylases, lipases, and nucleases, which help break down food that comes from the stomach.

The endocrine function of this organ is to release two hormones directly into the bloodstream from the islets of Langerhans. These are insulin and glucagon, which are primarily involved in regulating blood sugar (glucose) levels. When the body has enough energy, insulin signals the liver, muscles, and fat cells to begin absorbing this glucose from the blood, thus regulating blood sugar levels. In contrast, glucagon prevents these levels from falling to low levels by stimulating the organs to produce and secrete glucose. Striking the right balance is essential for health here.

Related conditions

The pancreas can play a role or be affected by a number of conditions and diseases. These include :

  • Perforation: Irregularities in the structure of the pancreas can lead to the formation of holes in the organ, in which case digestive enzymes leak into the abdominal cavity. In turn, this can damage the pancreas itself, as well as other organs in the area. Treatment often involves surgical removal of the pancreas, which is effective, but means that the patient will have to take additional enzymes and blood glucose regulators for the rest of their life.
  • Pancreatic cancer: This type of cancer is especially dangerous because it is usually only diagnosed at a very late stage. Risk factors for this condition include smoking, obesity, diabetes, and colon cancer. As with other cancers, treatment may include surgery, radiation therapy, chemotherapy, immunotherapy, and targeted work.
  • Type 1 diabetes: This is an autoimmune disease in which the immune system attacks cells involved in the production of insulin. It is the most common type of childhood diabetes, with the highest incidence during puberty, although it can also occur in adults. It leads to dangerous blood sugar levels. Therefore, sufferers need insulin injections to survive.
  • Type 2 diabetes: The most common form of this disease, type 2 diabetes, produces excessively high blood sugar levels due to resistance to insulin and the impaired ability of the pancreas to secrete this hormone. Treatment for this condition ranges from providing diet and lifestyle changes to taking one of a class of medications called biguanides.
  • Pancreatitis – this disease is characterized by inflammation of the pancreas as a result of damage to digestive enzymes; it can be acute (more temporary) or chronic. This is due to recurrent gallstones (mineral deposits in the gallbladder), excessive alcohol consumption, measles, mumps, scorpion stings, and a deficiency of alpha-1-antitrypsin, an important protein. As a result, patients experience constant pain in the upper abdomen, which radiates to other parts of the body. In about 15% of acute cases, this leads to low blood pressure, dehydration, and kidney or heart failure. Although milder cases can resolve on their own, treatment includes everything from antibiotics to surgery.
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