Logo

    Related Topics

    From Digestive System

    Body
    Main central region of the stomach.
    Splenic Flexure
    Bend between transverse and descending colon.
    Descending Colon
    Vertical segment of the colon on the left side.
    Quadrate Lobe
    Small lobe located between gallbladder and round ligament.
    Major Duodenal Papilla
    Opening for bile and pancreatic ducts into duodenum.
    Internal Anal Sphincter
    Involuntary muscle around anal canal.
    Neck of Pancreas
    Short section between head and body.
    Duodenal Bulb
    Initial section of duodenum closest to the stomach.
    Mesocolon
    Peritoneal fold attaching colon to posterior wall.
    Transverse Colon
    Horizontal part of the colon.
    Tongue
    Muscular organ aiding in taste, speech, and food manipulation.
    Teeth
    Structures in the jaws for mechanical breakdown of food.
    Falciform Ligament
    Connects liver to anterior abdominal wall.
    Duodenum
    First portion of the small intestine.
    Ascending Colon
    Vertical segment of the colon on the right side.
    Left Lobe
    Smaller lobe of the liver.
    Cheeks
    Lateral walls of the oral cavity composed of muscle and fat.
    Oropharynx
    Middle region of the pharynx behind the oral cavity.
    Hepatic Flexure
    Bend between ascending and transverse colon.
    External Anal Sphincter
    Voluntary muscle around anus.
    Ileocecal Valve
    Controls flow from ileum to cecum.
    Mesentery
    Fold of peritoneum anchoring intestines.
    Common Hepatic Duct
    Carries bile from liver to bile duct.
    Submandibular Glands
    Salivary glands beneath the mandible.
    Epiploic Appendages
    Fat-filled pouches attached to colon.

    Accessory Pancreatic Duct

    Reviewed by our medical team

    Secondary duct emptying into duodenum.

    Overview

    The accessory pancreatic duct (also known as the duct of Santorini) is a secondary duct of the pancreas that may serve as an alternative pathway for pancreatic enzymes to reach the duodenum. While it is variable in presence and size among individuals, when present and functional, it provides a supplementary route for pancreatic secretions, particularly in cases where the main pancreatic duct (duct of Wirsung) is obstructed or underdeveloped.

    Location

    The accessory pancreatic duct originates from the dorsal portion of the pancreas. Its typical course includes:

    • Beginning in the head of the pancreas

    • Running superior to the main pancreatic duct

    • Opening into the duodenum at the minor duodenal papilla, located approximately 2 cm above the major duodenal papilla (where the main duct empties)

    In some individuals, it communicates with the main pancreatic duct; in others, it remains as an isolated or rudimentary structure.

    Structure

    The accessory pancreatic duct is a small epithelial-lined tubular structure that:

    • Is composed of simple columnar epithelium, similar to the main duct

    • May have smooth muscle sphincters at its terminal portion (minor papilla), although these are often less developed than those at the major papilla

    • Varies significantly in size and patency

    Its development is linked embryologically to the dorsal pancreatic bud, while the main pancreatic duct arises from the ventral bud.

    Function

    The accessory pancreatic duct’s main function, when patent, is to:

    • Transport pancreatic enzymes (including amylase, lipase, and proteases) from the dorsal part of the pancreas to the duodenum

    • Act as an alternative route for pancreatic secretions when the main duct is blocked or narrowed

    It usually carries only a small portion of the total pancreatic output, especially if the main pancreatic duct is fully functional.

    Physiological Role(s)

    Though often vestigial or underutilized, the accessory pancreatic duct can serve roles in:

    • Reducing pressure buildup: Provides an auxiliary drainage path, potentially lowering intraductal pressure

    • Compensatory secretion: In congenital anomalies (e.g., pancreas divisum), it becomes the primary drainage route for a major part of the pancreas

    • Ensuring enzyme delivery: May help maintain digestive efficiency when the main pancreatic duct is anatomically compromised

    Clinical Significance

    The accessory pancreatic duct has relevance in various clinical conditions and diagnostic procedures:

    • Pancreas Divisum: A common congenital variant in which the dorsal and ventral pancreatic ducts fail to fuse. In such cases, the accessory duct becomes the primary outflow channel, which may lead to impaired drainage and recurrent pancreatitis.

    • Minor Papilla Stenosis: Narrowing of the minor duodenal papilla may cause outflow obstruction, contributing to dorsal pancreatitis or pain.

    • Endoscopic Evaluation: The duct may be visualized during ERCP (endoscopic retrograde cholangiopancreatography), especially in patients being evaluated for pancreas divisum or unexplained pancreatitis.

    • Surgical Considerations: Surgeons must be aware of its anatomy during pancreatic surgeries to avoid inadvertent injury or misidentification.

    • Imaging: MRCP (magnetic resonance cholangiopancreatography) and CT scans can sometimes visualize the accessory duct, particularly if it is dilated or functioning as the main drainage route.

    While often absent or vestigial, the accessory pancreatic duct may become highly significant in the context of congenital anomalies or pancreatic disease. Accurate recognition of its anatomy and variations is essential for proper diagnosis and management of pancreatic conditions.

    Did you know? Your gut contains millions of neurons and is often referred to as the "second brain."