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The pancreas is an organ of the digestive system and of the endocrine system.

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The pancreas has exocrine glands that produce enzymes that are very important for the digestion process.

Enzymes:

Lipase enzyme digests fats.

Amylase enzyme digests carbohydrates.

Trypsin, Chymotrypsinogen, and Carboxypeptidase digest proteins.

Nucleases digest nucleic acid.

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These pancreatic secretions are discharged into the main pancreatic duct (a network of ducts) upon food entry into the stomach. The pancreatic and common bile ducts unite to form the ampulla of Vater, situated at the duodenum, the first segment of the small intestine. Another vital digestive juice called bile is produced by the common bile duct, which has its origins in the liver and gallbladder. Digestion of fats, carbohydrates, and proteins is aided by the pancreatic juices and bile secreted into the duodenum.

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The endocrine component of the pancreas consists of islet cells (also called islets of Langerhans) that create and release important hormones directly into the bloodstream. Two of the main pancreatic hormones are insulin, which acts to lower blood sugar, and glucagon, which acts to raise blood sugar. Maintaining proper blood sugar levels is crucial to the functioning of key organs including the brain, liver, and kidneys.

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The pancreas receives its blood supply from several sources. 

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The pancreas receives its blood supply from several sources. 

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The uncinate process and head are supplied by the superior and inferior pancreaticoduodenal arteries, which are branches of the gastroduodenal and superior mesenteric arteries. The body and tail of the pancreas are supplied by pancreatic arteries that stem from the splenic, gastroduodenal, and superior mesenteric arteries. The major contributor is the splenic artery.

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The pancreas and its functions. Pancreas Functions, Location & Disease | Columbia Surgery. (n.d.). https://columbiasurgery.org/pancreas/pancreas-and-its-functions

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The pancreas is BOTH a gland and an organ!

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The pancreas makes around two liters of "juice" filled with enzymes every day!

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Pancreas should be more echogenic than the liver

Homogenous

Smooth in echotexture

Lies posterior to the stomach and bowel

Often obscured

Difficult to distinguish

Likely that not all of the pancreas will be visualized due to the plane it sits in; requires separate pictures of the head, body, and tail

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How Do I Get the BEST Image of the Pancreas?

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How Do I Get the BEST Image of the Pancreas?

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Pray and hope that God loves you. That is the entire post.

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More often than not, it just is not possible to get the best image of the Pancreas. However, to give a Sonographer the best shot, it is recommended that the patient has nothing by mouth for 6-8 hours. It is also recommended to use different scanning planes to view every angle, as well as alternating the patient's position.

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What Transducer Do I Use to Scan a Pancreas? 

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What Transducer Do I Use to Scan a Pancreas? 

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A low-frequency Curvilinear probe with 2.5-5 MHz is best.

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Pancreatic veins are responsible for draining deoxygenated blood from the pancreas. The anterior superior pancreaticoduodenal vein empties into the superior mesenteric vein, while the posterior variant empties into the hepatic portal vein. Both the anterior and posterior inferior pancreaticoduodenal veins drain into the superior mesenteric vein, while the pancreatic veins draining venous blood from the body and tail empty into the splenic vein.

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Pancreas. Kenhub. (n.d.). https://www.kenhub.com/en/library/anatomy/the-pancreas

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A 'normal variant' is an atypical finding that is seen in a percentage of the population, and mostly has no clinical significance. It is considered within the spectrum of normal findings.

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Pancreas Divisum

Annular Pancreas

Pancreas Agenesis

Ectopic Pancreas

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Pancreas Divisum is the most common pancreatic variant. It is present from birth, and is a consequence from a failed fusion of the dorsal and ventral pancreatic ducts resulting in two pancreatic ducts that are not joined together, but instead are separated and incompletely joined by very thin connections.

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Annular Pancreas is the second most common variant. It happens when the pancreatic tissue encircles the second portion of the duodenum (C-Loop) and results in bile flow obstruction.

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Pancreas Agenesis is incredibly uncommon. It is an absence of the body and tail of the pancreas, and is a result of an absence in the dorsal pancreatic bud. Agenesis is also linked to diabetes mellitus due to the majority of the islet cells being located in the dorsal pancreas.

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Ectopic Pancreas is an occurrence that involves pancreatic tissue that has no vascular or structural connection to the pancreas body. The tissue can be found in various places throughout the abdomen.

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Having trouble seeing the Pancreas? Look for these landmarks to know if you are in the right place!

Left Lobe of Liver

Gastroduodenal Artery

Common Bile Duct

Portal Splenic Confluence

Superior Mesenteric Artery

Aorta

Inferior Vena Cava

If none of these provide the confidence that beyond a shadow of a doubt you are looking at the Pancreas, throw some color on the image to locate the Portal Splenic Confluence. If flow is visualized, the Pancreas is just superior!

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The pancreas is active in both the digestive and the hormonal processes of the body. The digestive process being exocrine and the hormonal process being endocrine.

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The endocrine portion is arranged as discrete islets of Langerhans, which are composed of five different endocrine cell types; alpha, beta, delta, epsilon, and upsilon. They all secret at least five hormones including glucagon, insulin, somatostatin, ghrelin, and pancreatic polypeptide. The main hormones being glucagon and insulin. In the pancreas fails to sufficient insulin it leads to someone having diabetes mellitus.

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The exocrine gland secretes digestive enzymes. These enzymes are secreted into a network of ducts that join the main pancreatic duct. This runs the length of the pancreas.

The majority of the pancreas is made up of the exocrine portion (85% by mass) and secretes digestive enzymes, water and bicarbonate to assist in digestion. The bicarbonate helps in neutralizing the stomach acid. This is an important part of digestion as the small intestine is not made to handle the strong acids from the stomach. This is because the small intestine, unlike the stomach, lacks a thick protective mucous layer. Additionally, the digestive enzymes secreted by the pancreas reach their top tier function at a basic pH. This is achieved by the bicarbonate secretions of the pancreas.

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The pancreas has taste receptor cells that let it sense the presence of sugar.

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Petsko, E. (2018, December 25). 12 facts about the pancreas. Mental Floss. https://www.mentalfloss.com/article/566059/pancreas-facts

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Your pancreas releases hormones directly into your bloodstream. Hormones are chemicals that stimulate other cells or tissues into action. Insulin is an important hormone your pancreas makes.

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Staff, T. M. E. (2024, January 25). Quick facts: Pancreas. Merck Manuals Consumer Version. https://www.merckmanuals.com/home/quick-facts-digestive-disorders/biology-of-the-digestive-system/pancreas

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(n.d.). Pancreas. Cleveland Clinic. https://my.clevelandclinic.org/health/body/21743-pancreas

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@Our Pancreas PowerPoint

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Largest component of the pancreatic juices

Neutralizes chyme in the duodenum

Secretion stimulated by secretin

Secreted by cells lining the pancreatic duct

Protects mucosal lining

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The pancreas can digest itself

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Kim, S. S., Shin, H. C., & Hwang, J. A. (2019, June 28). Various Congenital Abnormalities and Anatomic Variants of the Pancreas: A Pictorial Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598607/

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(ignore my stuttering please)