Lymph Vessels of the Pancreas
The lymph vessels of the pancreas (Figure 26: 3, 3’) drain to the jejunal, right hepatic, left hepatic, duodenal, and splenic lymph nodes.
The lymph vessels from the right terminal part of the pancreas (Figure 26: 3) merge to form 1 to 2 trunks (Figure 26: l’), which run in the mesentery to the jejunal lymph nodes. From the remaining right half of the pancreas, most of the lymph vessels travel as several trunks to drain to the right hepatic lymph nodes (Figure 26: b), though some also open directly into the duodenal lymph node (Figure 26: a), which is located at the pancreas. The lymph vessels of the left half of the pancreas (Figure 26: 3’) drain to the splenic lymph nodes (Figure 26: d) and the left hepatic lymph node (Figure 26: c).
The lymph vessels of the pancreas are all very small and are prominent on both surfaces of the pancreas: on the right half, most of the lymph vessels are located on the ventral surface, while on the left half, most of the lymph vessels are on the dorsal surface.
The lymph vessels of the pancreas connect with the lymph vessels of the duodenum in such a way that the lymph vessels of the duodenum merge or anastomose with those of the pancreas. Due to this connection, the lymph vessels of the duodenum can be injected from the pancreas, and apparently, microorganisms can also travel by this route. I have often succeeded in injections of this type, but I have not succeeded in filling the smaller lymph vessels of the pancreas from the lymph vessels of the duodenum, which drain to the pancreas. The injection material penetrates, at most, from the lymph vessel of the duodenum over a short distance into the lymph vessel of the pancreas, evidently as far as the next valve.
In this respect, the results of my research agree exactly with those of Bartels [2], who was likely the first to study the lymphatic connections between the pancreas and duodenum carefully, first in dogs, but also in men and monkeys. Bartels explained the finding that the lymph vessels of the duodenum fill from pancreatic lymph vessels, but smaller lymph vessels of the pancreas do not fill from duodenal lymph vessels, as being due to the numerous valves present in the pancreatic lymph vessels preventing the reverse flow of lymph in these vessels – this is apparently the case. However, one then must assume, which Bartels does not point out, that the lymph vessels of the duodenum either do not have such valves, or at least have valves that do not completely close. This is evident from the fact that, when a main lymph vessel formed by the union of a duodenal lymph vessel with a pancreatic lymph vessel is injected, the injected fluid may be forced back in the duodenal lymph vessel up to its finer branches, but this is not seen in the pancreatic lymph vessel. Occasionally, the filling of 1 or 2 duodenal lymph vessels that form subperitoneal networks on the pancreas can be mistaken for more extensive filling of pancreatic lymphatics from the duodenal lymphatics.
Similar connections of the pancreatic lymph vessels with the lymph vessels of the stomach and the transverse colon could not be established, despite conducting a careful examination.
