- lt is a branch of the celiac trunk.
! Along upper border of pancreas (retro-peritoneal).
F Then reaches the spleen through lieno-renal ligament.
It has 2 or 3 terminal branches not communicating in the spleen. Therefore,
segmental resection of the spleen is possible.
2) Splenic vein ) receives the inferior mesenteric vein ) then unites with the
superior mesenteric vein to form the portal vein.
Lvm Oh Dra inaoe: To the aortic LNs around the celiac trunk.
1- The phrenico-colic Iigament is responsible for
growth of the spleen to the Rt. iliac fossa.
2- Spleen can grow towards the Lt. iliac fossa
when the phrenico-colic ligament is
infiltrated in chronic myeloid
leukemia or if the ligament is
- Draw 2 transverse lines at 9th & 11th ribs.
- Draw 2 vertical lines at midaxillary line &
scapular line from inferior angle of the
- /t,s a retroperitoneal organ.
- lt lies obliquely across the upper part of the posterior abdominal wall extending
from the duodenal curve to the hilum of the spleen.
. Lies within the concavity of the duodenum.
. It has a hook-like process called uncinate process, which projects upwards & to
- The CBD passes behind it close to the duodenum.
- The IVC & aorta posterior to it.
- The uncinate process is related anteriorly to superior mesenteric artery.
Cancer head of Pancreas may by fatal if infiltration of IVC & aorta occurs.
Cancer head of pancreas ) obstructive jaundice.
- Anterior Relations: Pyloro-duodenal junction.
- Posterior Relations: Junction between SMV & splenic v. to form the portal vein.
. The splenic artery runs along its
, lt crosses in front of the left kidney.
border while the splenic vein runs
Sursical Importance: the splenic vein is behind pancreas, so at modified Warren
operation ligation of the vein is difficult.
It lies in contact with the hilum of the spleen; in the lieno-renal ligament.
Tail is in the splenic ligament ) at splenectomy, injury of the tail leads to burst
Mqin poncteotic duct of Wirrung
- lt traverses the whole length of the gland & ends by joining the CBD at the ampulla
of Vater & discharges its contents through the major duodenal papilla.
- lt represents the duct of the ventral pancreatic bud proximally & the duct of the
dorsal pancreatic bud distally.
Accersory poncrectic duct of Scrntorini
- Usually joins the main pancreatic duct, rarely it becomes the main duct & opens
into the duodenum through the superior papilla.
* - Superior pancreatico-duodenat artery: from the gastro-duodenal artery. 7v-
- lnferior pancreatico-duodenal artery.'from the superior mesenteric artery.
t Both of them supply the head & the duodenum.
- The rest is supplied by branches of splenic & superior mesenteric arteries.
N.B: The pancreatica magna artery arises from the splenic artery.
Surgical lmpoftance.' at Whipple's operation, both pancreas & duodenum are
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Lvmph Drainaqe: To the celiac & superior mesenteric LNs.
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- It is the artery of forgut. It supplies the gut above the level of ampulla of Vater'
orioin: {F . lt arises from the abdominal aorta at the level of upper border of L1.
o lt supplies the foregut above the level of ampulla of Vater.
o Related to celiac ganglion on either side.
a-To pancreas: pancreatic branches to supply its body & tail.
- Short gastric arteries: pass in gastro-splenic liEjament.
- Lt. gastro-epiploic: supply Lt. part of greater curvature.
c-Terminal branches: to spleen.
3. Hepatic arteru: lts branches include:
a- Rt. gastric along the lesser curvature of the stomach.
-^-b- Gastro-duodenal artery which gives:
{f i- Rt. Gastro-epiploic:along greater curvature of the stomach.
{f "- Right hepatic artery: gives .c.y-s.!!9..A.ftey-to the gall bladder.
. Gastro-duodenal artery may cause fatal bleeding in perforated DU.
. Blood supply of duodenum & pancreas is the same (pancreatico-duodenal a.), so,
with removal of the head of pancreas we have to remove the duodenum
. Arises from the front of abdominal aorta at the level of lower border of L1.
,rt lt supplies the midgut from the level of ampulla of Vater till the Rt. % of the
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Posbriffscd fl'tory *ppildcdar afiery
1. lnferior pancreaticoduodenal arterv
It anastomoses v,vith the superior pancreatico-duodenal artery between the head
of pancreas & 2no part of the duodenum.
2. Jeiunal & ileal branches (12- 151
- lt forms the arterial arcades in the mesentery.
- The arcades are simple in jejunum & complex in ileum.
3. lleo-colic Arterv: it is the continuation of the SMA.
2. Appendicular branches (the continuation of the ileo-colic a.).
3, Anterior caecal & posterior caecal branches to the caecum.
4. Ascending branches anastomose with the descending branches of the Rt.
4. Riqht Golic Arterv: Its branches include:
1. Descending branches anastomose with ascending branch of ileocolic.
2. Ascending branches anastomose with the Rt. branches of the middle colic a.
5. Middle Colic Afterv: lts branches include:
1. Rt. branch anastomoses with ascending branches of Rt. colic.
2. Ll. branch anastomoses with ascending branches of superior Lt. colic artery.
IILB; Superiar mesenteric artery lies on the Lt. ode of superiar mesenteric u,ein
During colectomy, we ligate arteries arising from Rt. side of SMA; which are the
middle colic, Rt. colic & ileocolic, while those arising from Lt. side; which are jejunal &
ileal branches are kept; to avoid ischemia of jejunum & ileum.
Arise from the front of abdominal aorta at the level of lower border of L3.
It supplies the hindgut from lateral Ts of the transverse colon to the upper lz of the
1- Left Colic arterv: lts branches include:
a- Ascending branches anastomose with the Lt. branches of the middle colic.
b- Descending branches anastomose with sigmoid branches.
middle & inferior rectal arteries.
O rio in : SMV + splenic vein. # Cou rse
{r : [ :::*: 3"# [ il ?:r;i,ru l;:x"::: tt
. lt ascends in the free margin of the hepato-duodenal ligament (lesser omentum)
behind CBD to the right & the proper hepatic artery to the left.
. lt ends at the porta hepatis.
Portalvein drains the whole intra-abdominal alimentary tract + ant. abdominal wall
. Small pancreatic & duodenal veins.
o Para-umbilical veins into left branch of portal vein.
Pressu re: 10 - 20 cmHzO (7 - 11 mmHg).
Collateral Circulation ic Shunts
Around the umbilicus Anterior abdominal wall
Anal canal Middle & inferior rectal veins
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