The pancreatic duct or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct) is a duct joining the pancreas to the common bile duct. This supplies it with pancreatic juice from the exocrine pancreas, which aids in digestion.
The pancreatic duct joins the common bile duct just prior to the ampulla of Vater, after which both ducts perforate the medial side of the second portion of the duodenum at the major duodenal papilla. There are many anatomical variants reported, but these are quite rare.[2]
Accessory pancreatic ductedit
Most people have just one pancreatic duct. However, some have an additional accessory pancreatic duct, also called the Duct of Santorini. An accessory pancreatic duct can be functional or non-functional.[3][4] It may open separately into the second part of the duodenum,[3][4] which is dorsal, and usually (in 70% of people) drains into the duodenum via the minor duodenal papilla. In the other 30% of people, it drains into the main pancreatic duct, which drains into the duodenum via the major duodenal papilla. The main pancreatic duct and the accessory duct both eventually—either directly or indirectly—connect to the second part ('D2', the vertical segment) of the duodenum.
Compression, obstruction or inflammation of the pancreatic duct may lead to acute pancreatitis. The most common cause for obstruction is the presence of gallstones in the common bile duct, a condition called choledocholithiasis. Obstruction can also be due to duodenal inflammation in Crohn's disease.[7] A gallstone may get lodged in the constricted distal end of the ampulla of Vater, where it blocks the flow of both bile and pancreatic juice into the duodenum. Bile backing up into the pancreatic duct may initiate pancreatitis.[8] The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan.[9] Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85% of people.[10]
The pancreatic duct is also called the duct of Wirsung.[11] This is named after its discoverer, the German anatomistJohann Georg Wirsung (1589–1643).[12]
Interior of the descending portion of the duodenum, showing bile papilla.
Pancreas of a human embryo of five weeks.
Pancreas of a human embryo at end of sixth week.
Pancreatic duct Deep dissection.Anterior view.
Ultrasonography of a dilated pancreatic duct (in this case 9mm) due to pancreatic cancer.
Referencesedit
^Standring S, Borley NR, eds. (2008). Gray's anatomy : the anatomical basis of clinical practice. Brown JL, Moore LA (40th ed.). London: Churchill Livingstone. pp. 1163, 1177, 1185–6. ISBN978-0-8089-2371-8.
^Goel, Shivi; Rustagi, SM; Saha, S; Mehta, V; Suri, RK; Rath, G (July 2015). "Aberrant pancreatic ductal organisation: a case report". Surgical and Radiologic Anatomy. 37 (5): 543–6. doi:10.1007/s00276-015-1474-z. PMID 25840941. S2CID 6917153.
^ abMoore KL, Dalley AF. 2006. Clinically Oriented Anatomy. 5th Ed. Lippincott Williams & Wilkins. p 287.
^ ab1. Mchonde GJ, Gesase AP. Termination pattern of main and accessory pancreatic ducts among Tanzanians. Anatomy Journal of Africa. 2014; 3(1):223–227.
^Edge, Mark D (2007). "Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation". World Journal of Gastroenterology. 13 (11): 1701–1705. doi:10.3748/wjg.v13.i11.1701. ISSN 1007-9327. PMC4146949. PMID 17461473.
^Glaser, J.; Högemann, B.; Krummenerl, T.; Schneider, M.; Hultsch, E.; Van Husen, N.; Gerlach, U. (October 1987). "Sonographic imaging of the pancreatic duct: New diagnostic possibilities using secretin stimulation". Digestive Diseases and Sciences. 32 (10): 1075–1081. doi:10.1007/BF01300191. ISSN 0163-2116. PMID 3308373. S2CID 20674576.
^Eisenscher, Albert; Weill, Francis (1979). "Ultrasonic visualization of Wirsung's duct: Dream or reality?". Journal of Clinical Ultrasound. 7 (1): 41–44. doi:10.1002/jcu.1870070112. ISSN 1097-0096. PMID 108297. S2CID 21851681.
pancreatic, duct, pancreatic, duct, duct, wirsung, also, major, pancreatic, duct, existence, accessory, pancreatic, duct, duct, joining, pancreas, common, bile, duct, this, supplies, with, pancreatic, juice, from, exocrine, pancreas, which, aids, digestion, pa. The pancreatic duct or duct of Wirsung also the major pancreatic duct due to the existence of an accessory pancreatic duct is a duct joining the pancreas to the common bile duct This supplies it with pancreatic juice from the exocrine pancreas which aids in digestion Pancreatic ductThe pancreatic ductDetailsPrecursorPancreatic budIdentifiersLatinductus pancreaticusMeSHD010183TA98A05 9 01 015TA23129FMA10419Anatomical terminology edit on Wikidata 1 Bile ducts 2 Intrahepatic bile ducts 3 Left and right hepatic ducts 4 Common hepatic duct 5 Cystic duct 6 Common bile duct 7 Ampulla of Vater 8 Major duodenal papilla 9 Gallbladder 10 11 Right and left lobes of liver 12 Spleen 13 Esophagus 14 Stomach 15 Pancreas 16 Accessory pancreatic duct 17 Pancreatic duct 18 Small intestine 19 Duodenum 20 Jejunum 21 22 Right and left kidneys The front border of the liver has been lifted up brown arrow 1 Contents 1 Structure 1 1 Accessory pancreatic duct 2 Clinical significance 3 History 4 Additional images 5 ReferencesStructure editThe pancreatic duct joins the common bile duct just prior to the ampulla of Vater after which both ducts perforate the medial side of the second portion of the duodenum at the major duodenal papilla There are many anatomical variants reported but these are quite rare 2 Accessory pancreatic duct edit Most people have just one pancreatic duct However some have an additional accessory pancreatic duct also called the Duct of Santorini An accessory pancreatic duct can be functional or non functional 3 4 It may open separately into the second part of the duodenum 3 4 which is dorsal and usually in 70 of people drains into the duodenum via the minor duodenal papilla In the other 30 of people it drains into the main pancreatic duct which drains into the duodenum via the major duodenal papilla The main pancreatic duct and the accessory duct both eventually either directly or indirectly connect to the second part D2 the vertical segment of the duodenum It is named for Giovanni Domenico Santorini 5 6 nbsp Formation of an accessory pancreatic ductClinical significance editCompression obstruction or inflammation of the pancreatic duct may lead to acute pancreatitis The most common cause for obstruction is the presence of gallstones in the common bile duct a condition called choledocholithiasis Obstruction can also be due to duodenal inflammation in Crohn s disease 7 A gallstone may get lodged in the constricted distal end of the ampulla of Vater where it blocks the flow of both bile and pancreatic juice into the duodenum Bile backing up into the pancreatic duct may initiate pancreatitis 8 The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan 9 Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85 of people 10 Pancreatic ductal carcinoma is a common form of pancreatic cancer History editThe pancreatic duct is also called the duct of Wirsung 11 This is named after its discoverer the German anatomist Johann Georg Wirsung 1589 1643 12 Additional images edit nbsp ERCP image showing the pancreatic duct and biliary tree nbsp Accessory digestive system nbsp Interior of the descending portion of the duodenum showing bile papilla nbsp Pancreas of a human embryo of five weeks nbsp Pancreas of a human embryo at end of sixth week nbsp Pancreatic duct Deep dissection Anterior view nbsp Ultrasonography of a dilated pancreatic duct in this case 9mm due to pancreatic cancer References edit Standring S Borley NR eds 2008 Gray s anatomy the anatomical basis of clinical practice Brown JL Moore LA 40th ed London Churchill Livingstone pp 1163 1177 1185 6 ISBN 978 0 8089 2371 8 Goel Shivi Rustagi SM Saha S Mehta V Suri RK Rath G July 2015 Aberrant pancreatic ductal organisation a case report Surgical and Radiologic Anatomy 37 5 543 6 doi 10 1007 s00276 015 1474 z PMID 25840941 S2CID 6917153 a b Moore KL Dalley AF 2006 Clinically Oriented Anatomy 5th Ed Lippincott Williams amp Wilkins p 287 a b 1 Mchonde GJ Gesase AP Termination pattern of main and accessory pancreatic ducts among Tanzanians Anatomy Journal of Africa 2014 3 1 223 227 synd 3087 at Who Named It G D Santorini Observationes anatomicae Venetiis apus J B Recurti 1724 American Gastroenterological Association Archived from the original on 2008 06 07 Retrieved 2010 03 15 Moore Keith L Dalley Arthur F 2006 Clinically Oriented Anatomy Fifth Edition Lippincott Williams amp Wilkins p 287 ISBN 0 7817 3639 0 Edge Mark D 2007 Clinical significance of main pancreatic duct dilation on computed tomography Single and double duct dilation World Journal of Gastroenterology 13 11 1701 1705 doi 10 3748 wjg v13 i11 1701 ISSN 1007 9327 PMC 4146949 PMID 17461473 Glaser J Hogemann B Krummenerl T Schneider M Hultsch E Van Husen N Gerlach U October 1987 Sonographic imaging of the pancreatic duct New diagnostic possibilities using secretin stimulation Digestive Diseases and Sciences 32 10 1075 1081 doi 10 1007 BF01300191 ISSN 0163 2116 PMID 3308373 S2CID 20674576 Eisenscher Albert Weill Francis 1979 Ultrasonic visualization of Wirsung s duct Dream or reality Journal of Clinical Ultrasound 7 1 41 44 doi 10 1002 jcu 1870070112 ISSN 1097 0096 PMID 108297 S2CID 21851681 doctor 2941 at Who Named It Retrieved from https en wikipedia org w index php title Pancreatic duct amp oldid 1198754969, wikipedia, wiki, book, books, library,
