Abstract
Introduction: Anomalies and variants of development of the pancreas are relatively frequent. These variations can often lead to misdiagnosis and unnecessary medical procedures. Although, pancreatic diseases are a constantly researched field, fundamental research is relatively understudied and re-evaluation of the pancreatic morphology is performed rarely.
Aim: The goal of the current study was to analyse pancreatic surface morphology by means of macroscopic anatomical dissection of 78 organ complex.
Material and methods: The anatomy of the pancreas was studied by means of macroscopic anatomical dissection. The study was performed on 78 organ complexes (the pancreas, spleen, and duodenum with surrounding abdominal fat) donated to the department of human anatomy from patients who died of causes not related to pancreatic diseases. The organs were fixed in a 10% formalin solution separately to accurately preserve their forms. The organs were measured by a caliper.
Results: The lie of the pancreas was classified according to Kreel and co-workers into 6 types: oblique shape in 11.54% of cases, sigmoid – 30.77%, transverse – 25.64%, horseshoe – 11.54%, L-shaped – 14.1%, and inverted V shape in 5.13%. Moreover, there were two possible L-shapes, the classical (8.97%) and inverted L-shape (5.13%). In one case, the pancreas had an unusual M-shape (1.28%). One specimen was a case of short pancreas (1.28%). Surface clefts were encountered in 17.95% of cases and in 5.13% of these cases, there was a branch of the splenic artery.
Conclusions: The current study demonstrates variations in the lie of the pancreas as well as several new possible variants. Moreover, we propose a modified classification based on these findings. Therefore, the pancreas can have an oblique, sigmoid, transverse, horseshoe, L shape, inverted L, inverted V, and M shaped lie. Pancreatic clefts are another frequently encountered variation that should be kept in mind. The size of the pancreas alone is variable and should be analyzed together with its structure to avoid possible misinterpretation.