Clinical features

1 Rarely, the two developing segments of the pancreas completely surround the second part of the duodenum ('annular pancreas') and may produce duodenal obstruction.

Annular Pancreas Image
Fig. 78 Development of the intestinal adnexae.

2 Note from the posterior relations of the pancreas that a neoplasm of the head of the pancreas will produce obstructive jaundice by compressing the common bile duct. An extensive growth in the body of the gland may cause portal or inferior vena caval obstruction.

3 Anterior to the pancreas lies the stomach, separated from it by the lesser sac. This sac may become closed off and distended with fluid either from perforation of a posterior gastric ulcer or from the outpouring of fluid in acute pancreatitis, forming a pseudocyst of the pancreas. Such a collection may almost fill the abdominal cavity.

Tail of pancreas

Surface related to s across les:

Splenic artery

Surface related to s across les:

Splenic Flexure Syndrome

_Left kidney

Fig. 79 The spleen and its immediate relations.

_Left kidney

Splenic flexure

Fig. 79 The spleen and its immediate relations.

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