LO2 - Pancreas

2. Diagram the vascular supply to the duodenum and pancreas, and describe the collateral blood flow between the celiac and superior mesenteric arteries.

The blood supply to the pancreas and duodenum is sourced from both the celiac trunk and the superior mesenteric a. When considering the regions served, it may be easier to consider the blood supply of the duodenum and head & neck of the pancreas separately from the supply to the body and tail of the pancreas.

The duodenum and head & neck of the pancreas are served:

  • Superiorly, by branches of the celiac trunk:
    • Gastroduodenal a. (& brs.)
      • Anterior superior pancreaticoduodenal a., &
      • Posterior superior pancreaticoduodenal a., and
  • Inferiorly, by branches of the SMA:
    • Inferior pancreaticoduodenal a.
      • Anterior br.,
      • Posterior br.

The gastroduodenal a. branches from the common hepatic a. and descends toward the head of the pancreas posterior to the retroperitoneal portion of the superior (1st) part of the duodenum. A perforating duodenal ulcer may jeopardize the gastroduodenal a., the (common) bile duct, or the hepatic portal v.

The body and tail of the pancreas are predominantly served by the celiac trunk (via the splenic a.). These branches include:

  • Splenic a.
    • Dorsal pancreatic a.inferior pancreatic a.
    • Greater pancreatic a.
    • Artery to the tail of pancreas

Very frequently, anastomoses may be found between the dorsal pancreatic a. and the pancreaticoduodenal arteries.