The head is the widest part of the pancreas, nestled inside the C-shaped loop of the duodenum to the right of the superior mesenteric vessels. It lies in front of the inferior vena cava and right renal vein. The common bile duct runs in a groove on its back surface or through its substance on the way to the duodenum.
| Location | Within the curve of the duodenum, right of the superior mesenteric vein, in front of the inferior vena cava and right renal vein at about L2 |
|---|---|
| Parts |
|
| Nerve Supply | Vagus nerve (parasympathetic, secretomotor); Greater and lesser splanchnic nerves via the coeliac and superior mesenteric plexuses (sympathetic and pain) |
| Blood Supply | Anterior and posterior superior pancreaticoduodenal arteries; Anterior and posterior inferior pancreaticoduodenal arteries |
| Venous drainage |
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| Lymphatic drainage |
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Produces digestive enzymes and bicarbonate and hosts the terminal common bile duct and main pancreatic duct as they reach the duodenum.
Most pancreatic cancers arise in the head and press on the common bile duct, causing painless obstructive jaundice and sometimes a palpable, non-tender gallbladder (Courvoisier sign). Resection requires a pancreaticoduodenectomy (Whipple operation). Inflammation in the groove between the head and the duodenum (groove pancreatitis) can mimic cancer.
Ductal adenocarcinoma in the head that blocks the bile duct early, causing jaundice, dark urine, pale stools and itching.
Uncommon form of chronic pancreatitis in the groove between the pancreatic head, duodenum and bile duct, often linked to alcohol, that can mimic a tumour.
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