Pancreas: peritoneal reflections, ligamentous connections, and pathways of disease spread

The pancreas is a retroperitoneal organ with a close anatomic relationship to the peritoneal reflections in the abdomen, including the transverse mesocolon and the small bowel mesentery, and is directly contiguous to peritoneal ligaments such as the hepatoduodenal ligament, gastrohepatic ligament, splenorenal ligament, gastrocolic ligament, and the greater omentum. Understanding of these anatomic relationships of the pancreas is aided by knowledge of its embryologic development. These reflections and ligaments are potential pathways for spread of disease processes such as pancreatitis and pancreatic carcinoma. One can recognize these ligaments and reflections by identifying the blood vessels that traverse them.