胰管
| 胰管 | |
|---|---|
 胰管 | |
 | |
| 基本信息 | |
| 发育自 | 胰芽 |
| 标识字符 | |
| 拉丁文 | ductus pancreaticus |
| MeSH | D010183 |
| TA98 | A05.9.01.015 |
| TA2 | 3129 |
| FMA | FMA:10419 |
| 格雷氏 | p.1202 |
| 《解剖學術語》 [在维基数据上编辑] | |
胰管或Wirsung管（由于存在副胰管，也称主胰管）是连接胰腺和胆总管的管道。为其提供了来自外分泌胰腺的胰液，有助于消化。
在进食时, 胰液会通过胰管流入消化道中消化蛋白质[1]。若胰管损伤，胰液会外渗到腹腔引发感染、腹腔出血等并发症, 严重的会导致生物体死亡[2][3]。
结构
[编辑]胰管在法特壶腹之前与胆总管汇合，之后两条胰管在十二指肠大乳头处穿通十二指肠第二部分的内侧。 报告了许多解剖变异，但非常罕见。[4]
副胰管
[编辑]大多数人只有一根胰管。有些人有额外的副胰管，也称为圣托里尼管。副胰管可以是功能性的或非功能性的。[5][6]可以单独打开到十二指肠的第二部分，即背侧，通常（在70%的人中）通过十二指肠小乳头流入十二指肠。[5][6]在另外30%的人中，它排入主胰管，主胰管通过十二指肠大乳头排入十二指肠。主胰管和副管最终都直接或间接地连接到十二指肠的第二部分（'D2'，垂直段）。
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副胰管的形成
临床意义
[编辑]胰管受压、令胰液受到阻塞或炎症可能导致急性胰腺炎。梗阻的最常见原因是胆总管中存在胆结石，称为胆总管结石。阻塞也可能是由于克罗恩病中的十二指肠炎症。[7] 胆结石可能会卡在法特壶腹狭窄的远端，阻止胆汁和胰液流入十二指肠。胆汁回流到胰管可能引发胰腺炎。[5]CT上胰管头部大于3mm，体部或尾部大于2mm，一般认为胰管异常扩大。[8]75%至85%的人可通过超声检查显示胰管或部分胰管。[9]
历史
[编辑]胰管也称为Wirsung管。[10]以其发现者德国解剖学家Johann Georg Wirsung（1589–1643）的名字命名。[11]
附加图像
[编辑]
参考文献
[编辑]- ^ Liu, Rong; Liu, Qu; Wang, Zizheng; Zhang, Xiuping; Zhang, Zhuochao; Chang, Zhenyu; Wang, Fei; Wang, Chao; Zhang, Gong. Theory and practice of pancreatic duct (repair) surgery. Chinese Science Bulletin. 2023-06-01, 68 (18): 2376–2387. doi:10.1360/TB-2022-1308.
- ^ McMillan, MT; Soi, S; Asbun, HJ; Ball, CG; Bassi, C; Beane, JD; Behrman, SW; Berger, AC; Bloomston, M; Callery, MP; Christein, JD; Dixon, E; Drebin, JA; Castillo, CF; Fisher, WE; Fong, ZV; House, MG; Hughes, SJ; Kent, TS; Kunstman, JW; Malleo, G; Miller, BC; Salem, RR; Soares, K; Valero, V; Wolfgang, CL; Vollmer CM, Jr. Risk-adjusted Outcomes of Clinically Relevant Pancreatic Fistula Following Pancreatoduodenectomy: A Model for Performance Evaluation.. Annals of surgery. 2016-08, 264 (2): 344–52. PMID 26727086. doi:10.1097/SLA.0000000000001537.
- ^ McMillan, MT; Zureikat, AH; Hogg, ME; Kowalsky, SJ; Zeh, HJ; Sprys, MH; Vollmer CM, Jr. A Propensity Score-Matched Analysis of Robotic vs Open Pancreatoduodenectomy on Incidence of Pancreatic Fistula.. JAMA surgery. 2017-04-01, 152 (4): 327–335. PMID 28030724. doi:10.1001/jamasurg.2016.4755.
- ^ Goel, Shivi; Rustagi, Shaifaly Madan; Saha, Susmita; Mehta, Vandana; Suri, Rajesh Kumar; Rath, Gayatri. Aberrant pancreatic ductal organisation: a case report. Surgical and radiologic anatomy: SRA. 2015-07, 37 (5) [2022-07-04]. ISSN 1279-8517. PMID 25840941. doi:10.1007/s00276-015-1474-z. （原始内容存档于2022-07-06）.
- ^ 5.0 5.1 5.2 Abstracts: Presented at the Winter Meeting of the British Association of Clinical Anatomists, 20 December 2005, University of Sheffield, Sheffield, United Kingdom. Clinical Anatomy. 2006-04, 19 (3) [2022-07-04]. ISSN 0897-3806. doi:10.1002/ca.20305. （原始内容存档于2022-07-05） （英语）.
- ^ 6.0 6.1 Mchonde, Gabriel J.; Gesase, Ainory Peter. Termination pattern of the main and accessory pancreatic ducts among Tanzanians. Anatomy Journal of Africa. 2014, 3 (1) [2022-07-04]. ISSN 2305-9478. doi:10.4314/aja.v3i1. （原始内容存档于2022-06-15） （英语）.
- ^ Moolsintong, Picha; Loftus, Edward V.; Chari, Suresh T.; Egan, Laurence J.; Tremaine, William J.; Sandborn, William J. Acute pancreatitis in patients with Crohn's disease: clinical features and outcomes. Inflammatory Bowel Diseases. 2005-12, 11 (12) [2022-07-04]. ISSN 1078-0998. PMID 16306770. doi:10.1097/01.mib.0000186485.30623.ad. （原始内容存档于2022-07-05）.
- ^ Edge, Mark-D.; Hoteit, Maarouf; Patel, Amil-P.; Wang, Xiaoping; Baumgarten, Deborah A.; Cai, Qiang. Clinical significance of main pancreatic duct dilation on computed tomography: single and double duct dilation. World Journal of Gastroenterology. 2007-03-21, 13 (11) [2022-07-04]. ISSN 1007-9327. PMC 4146949
. PMID 17461473. doi:10.3748/wjg.v13.i11.1701. （原始内容存档于2022-07-05）.
- ^ Glaser, J.; Högemann, B.; Krummenerl, T.; Schneider, M.; Hultsch, E.; van Husen, N.; Gerlach, U. Sonographic imaging of the pancreatic duct. New diagnostic possibilities using secretin stimulation. Digestive Diseases and Sciences. 1987-10, 32 (10) [2022-07-04]. ISSN 0163-2116. PMID 3308373. doi:10.1007/BF01300191. （原始内容存档于2022-02-05）.
- ^ Eisenscher, A.; Weill, F. Ultrasonic visualization of Wirsung's duct: dream or reality?. Journal of clinical ultrasound: JCU. 1979-02, 7 (1) [2022-07-04]. ISSN 0091-2751. PMID 108297. doi:10.1002/jcu.1870070112. （原始内容存档于2022-07-05）.
- ^ Howard, J. M.; Hess, W.; Traverso, W. Johann Georg Wirsüng (1589-1643) and the pancreatic duct: the prosector of Padua, Italy. Journal of the American College of Surgeons. 1998-08, 187 (2). ISSN 1072-7515. PMID 9704970. doi:10.1016/s1072-7515(98)00136-7.
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