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Bile backing up into the pancreatic duct may initiate pancreatitis. [8] The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan. [9] Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85% of people. [10]
In about 10% of adults, an accessory pancreatic duct may be present if the main duct of the dorsal bud of the pancreas does not regress; this duct opens into the minor duodenal papilla. [11] If the two buds themselves, each having a duct, do not fuse, a pancreas may exist with two separate ducts, a condition known as a pancreas divisum .
Common hepatic duct 5. Cystic duct 6. Common bile duct 7. Ampulla of Vater 8. Major duodenal papilla 9. Gallbladder 10–11. Right and left lobes of liver 12. Spleen 13. Esophagus 14. Stomach 15. Pancreas: 16. Accessory pancreatic duct 17. Pancreatic duct 18. Small intestine: 19. Duodenum
The minor papilla drains the duct of Santorini, superior in position to the major papilla. In pancreatic divisum, in which the minor papilla drains the bulk of pancreatic secretions and major drains a minority of secretions (opposite of normal), a Santorinicele may develop leading to obstructed secretions/reflux resulting in pancreatitis.
When present, the sphincter is known as the sphincter of Helly, and the duct as the accessory pancreatic duct of Santorini. In 10% of people, the minor duodenal papilla is the prime duct for drainage of the pancreas, [1] although in others it may not be present at all. [2]
The ductal pancreas network originates from the central pancreatic duct—this main duct with the bile duct opens into the duodenum. The ductal cells of the main pancreatic duct are bound by connective tissue and produce a columnar epithelium. [3] Interlobular ducts originate from the main pancreatic duct and connect the various pancreatic lobes.
The embryology also explains the strange zig-zag course of the main pancreatic duct and the occasional appearance of an accessory pancreatic duct. The uncinate process, unlike the remainder of the organ, passes posteriorly to the superior mesenteric vein (it can pass posteriorly to the superior mesenteric artery , but this is less common).
Common hepatic duct 5. Cystic duct 6. Common bile duct 7. Ampulla of Vater 8. Major duodenal papilla 9. Gallbladder 10–11. Right and left lobes of liver 12. Spleen 13. Esophagus 14. Stomach 15. Pancreas: 16. Accessory pancreatic duct 17. Pancreatic duct 18. Small intestine: 19. Duodenum