Pancreas in Longitudinal Sections

115 Duodenum lateral to head of pancreas

116 Head of pancreas, bile duct
117 Head of pancreas, bile duct
118 Head of pancreas, hilar vessels, vena cava
119 Head of pancreas, superior mesenteric vein,
uncinate process
120 Head of pancreas, superior mesenteric vein,
uncinate process
121 Body of pancreas, splenic vein
122 Body of pancreas, splenic vein,
superior mesenteric artery, aorta
123 Body of pancreas, splenic vein
124 Tail of pancreas, splenic artery and vein,
renal artery and vein
125 Tail of pancreas, splenic artery and vein,
renal artery and vein
126 Tail of pancreas

Head of the Pancreas in Transverse Sections

127 Section cranial to head of pancreas, vena cava,
splenic vein
128 Head of pancreas, vena cava, superior mesenteric vein
129 Head of pancreas, vena cava, superior mesenteric vein,
uncinate process, common bile duct
130 Head of pancreas, vena cava, superior mesenteric vein,
uncinate process, gallbladder

Body of the Pancreas in Transverse Sections

131 Scan cranial to body of pancreas, celiac trunk
132 Body of pancreas, splenic vein
133 Body of pancreas, splenic vein, superior mesenteric
artery, aorta
134 Left renal artery and vein, superior mesenteric artery
and vein, aorta
 Tail of the Pancreas in Transverse Sections
135 Tail of pancreas, splenic artery
136 Tail of pancreas, splenic vein
137 Tail of pancreas, gas in stomach
138 Tail of pancreas

Transsplenic View of the Tail of the Pancreas

in Longitudinal Sections
139 Scan posterior to tail of pancreas, spleen, kidney
140 Spleen, tail of pancreas, kidney
141 Spleen, tail of pancreas, kidney
142 Scan anterior to tail of pancreas, spleen, stomach

Transsplenic View of the Tail of the Pancreas

in Transverse Sections
143 Spleen, tail of pancreas, kidney
144 Spleen, tail of pancreas, kidney

Details of the Pancreas

145 Transverse scan of pancreatic duct
146 Longitudinal scan of pancreatic duct
 136
Pancreas

115 Duodenum lateral to head of pancreas

116 Head of pancreas, bile duct

 Pancreas in Longitudinal Sections 137

73
20 76

17 36

The head of the pancreas lies in the duodenal loop of the

duodenum and is bounded laterally by the duodenum.

20 73

4 41

17 36

10

The bile duct, hepatic artery, and portal vein

are located cranial to the head of the pancreas.
 138
Pancreas

117 Head of pancreas, bile duct

118 Head of pancreas, hilar vessels, vena cava

 Pancreas in Longitudinal Sections 139

73
22

4 41
36
23 17

10

The bile duct runs posteriorly in the head of the pancreas to the papilla,
which usually cannot be visualized with ultrasound.

70

22

4
41
17

10

8
90
92

The head of the pancreas lies against the anterior surface of the vena cava
and is bordered cranially by the main trunk of the portal vein.
 140
Pancreas

119 Head of pancreas, superior mesenteric vein,

uncinate process

120 Head of pancreas, superior mesenteric vein,

uncinate process
 Pancreas in Longitudinal Sections 141

22
41
4 19
94
17 44

23 10
8

90

The uncinate process runs posteriorly around the mesenteric vein,

coming between that vessel and the vena cava.

22
41

4 19 94
44

10 8

90

The superior mesenteric vein marks the boundary

between the head and body of the pancreas.
 142
Pancreas

121 Body of pancreas, splenic vein

122 Body of pancreas, splenic vein,

superior mesenteric artery, aorta
 Pancreas in Longitudinal Sections 143

22 42

4 18 19

96

90

The body of the pancreas is the narrowest part

of the organ in its ventrodorsal dimension.

70
21
42
18 7
3

1 15

90

The celiac trunk is cranially adjacent to the body of the

pancreas. The splenic vein and body of the pancreas
cross over the superior mesenteric artery.
 144
Pancreas

123 Body of pancreas, splenic vein

124 Tail of pancreas, splenic artery and vein,

renal artery and vein
 Pancreas in Longitudinal Sections 145

70
21
42

18 15
6 9
5

The left margin of the aorta marks the junction

between the body and tail of the pancreas.

21
43

5 18
6
9 15

A longitudinal scan at the junction of the body and tail

of the pancreas displays four vessels in cross section:
the splenic artery, splenic vein, renal artery, and renal vein.
 146
Pancreas

125 Tail of pancreas, splenic artery and vein,

renal artery and vein

126 Tail of pancreas

 Pancreas in Longitudinal Sections 147

21

43

74 5 18
6
15
9

The tail of the pancreas often has

a plump appearance in cross section.

21

43

15

The tail of the pancreas can be completely visualized

in an anterior scan only if acoustic conditions are good.
 148
Pancreas

127 Section cranial to head of pancreas, vena cava,

splenic vein

128 Head of pancreas, vena cava, superior mesenteric vein

 Head of the Pancreas in Transverse Sections 149

21

22 42

18
43
20
10 1

90

The body of the pancreas overlies the superior mesenteric vein.

All parts of the gland that lie to the right of the superior
mesenteric vein are designated as the head of the pancreas.

21

22

41 19
94
36 44
20 1
10

60

90

The uncinate process extends between

the vena cava and superior mesenteric vein.
 150
Pancreas

129 Head of pancreas, vena cava, superior mesenteric vein,

uncinate process, common bile duct

130 Head of pancreas, vena cava, superior mesenteric vein,

uncinate process, gallbladder
 Head of the Pancreas in Transverse Sections 151

21
22

41 19
30

20 36
1 94
10

60 90

The common bile duct is visible at the right border

of the pancreatic head in transverse section.

21 70
22

30 41 19
20
44
36 1 94
10

60
90

The head of the pancreas lies between the liver,

gallbladder, vena cava, and superior mesenteric vein.
 152
Pancreas

131 Scan cranial to body of pancreas, celiac trunk

132 Body of pancreas, splenic vein

 Body of the Pancreas in Transverse Sections 153

70
21
43
17 5
4 3
94
10 1

90

The body of the pancreas is bounded cranially by the celiac trunk

and its two branches, the hepatic artery and splenic artery.

4 21
70
41 42
17
36 7
5
10 1 43

90

The borders of the healthy pancreas form a

continuous outline from head to body to tail.
 154
Pancreas

133 Body of pancreas, splenic vein,

superior mesenteric artery, aorta

134 Left renal artery and vein,

superior mesenteric artery and vein, aorta
 Body of the Pancreas in Transverse Sections 155

21
70
42
45
18 43
7
41 44
10 1

90

The splenic vein is the landmark for locating the pancreas.

The superior mesenteric artery lies between the splenic vein and the aorta,
appearing as an echo-free spot surrounded by bright echoes.

70
21 7
18
1 15
10
9

90

When the renal vessels are displayed in a transverse scan,

usually the pancreas is no longer visualized.
 156
Pancreas

135 Tail of pancreas, splenic artery

136 Tail of pancreas, splenic vein

 Tail of the Pancreas in Transverse Sections 157

21

94
10
1
43

90

The tail of the pancreas is located well posteriorly,

on the left side of the aorta.

21

4 94
3 18
10 43
1

90

The tail of the pancreas is angled sharply posterior

from the body and extends a variable distance between the
stomach and the upper renal pole toward the splenic hilum.
 158
Pancreas

137 Tail of pancreas, gas in stomach

138 Tail of pancreas

 Tail of the Pancreas in Transverse Sections 159

21
42 70
18
45
94

10
1
43

90

The junction between the body and tail of the pancreas

is located at the level of the left aortic margin.

70

42

18
94
10 43
1

90

The tail of the pancreas is the most difficult part

of the gland to evaluate with ultrasound.
 160
Pancreas

139 Scan posterior to tail of pancreas, spleen, kidney

140 Spleen, tail of pancreas, kidney

Transsplenic View of the Tail of the Pancreas in Longitudinal Sections 161

50

61

The tail of the pancreas is scanned intercostally through

the spleen. Kidney and spleen serve as landmarks.

50

43

61
18

The tail of the pancreas is located in the splenic hilum

between the spleen and the kidney.
 162
Pancreas

141 Spleen, tail of pancreas, kidney

142 Scan anterior to tail of pancreas, spleen, stomach

Transsplenic View of the Tail of the Pancreas in Longitudinal Sections 163

79
50

43 94

18
15

Interference from bowel gas is often encountered

caudal to the tail of the pancreas.

50 18

70

The stomach is a source of numerous artifacts

anterior to the tail of the pancreas.
 164
Pancreas

143 Spleen, tail of pancreas, kidney

144 Spleen, tail of pancreas, kidney

 Transsplenic View of the Tail of the Pancreas in Transverse Sections 165

50
18 61

70

15
43

94

In transverse sections as well, the spleen is used as an

acoustic window for scanning the tail of the pancreas.

70

15
43
61
94

The tail of the pancreas lies in an angle

between the spleen and the kidney.
 166
Pancreas

145 Transverse scan of pancreatic duct

146 Longitudinal scan of pancreatic duct

 Details of the Pancreas 167

24 21
22 70

30
42 45
20 94
19
43
41
44

The pancreatic duct has a variable course. It usually runs

in the ventrocranial part of the parenchyma, appearing
sonographically as two parallel echogenic lines.

24

94 70
20
21
94
45
42 18
5

In this plane the pancreatic duct appears as a fine,

tubular structure with a luminal diameter up to 3 mm.
It is located slightly anterior to the center of the gland.