{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T23:30:54Z","timestamp":1774395054178,"version":"3.50.1"},"reference-count":26,"publisher":"Pensoft Publishers","issue":"2","license":[{"start":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T00:00:00Z","timestamp":1651276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p><jats:bold>Introduction<\/jats:bold>: 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.<\/jats:p>\n          <jats:p><jats:bold>Aim<\/jats:bold>: The goal of the current study was to analyse pancreatic surface morphology by means of macroscopic anatomical dissection of 78 organ complex.<\/jats:p>\n          <jats:p><jats:bold>Material and methods<\/jats:bold>: 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.<\/jats:p>\n          <jats:p><jats:bold>Results<\/jats:bold>: The lie of the pancreas was classified according to Kreel and co-workers into 6 types: oblique shape in 11.54% of cases, sigmoid \u2013 30.77%, transverse \u2013 25.64%, horseshoe \u2013 11.54%, L-shaped \u2013 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.<\/jats:p>\n          <jats:p><jats:bold>Conclusions<\/jats:bold>: 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.<\/jats:p>","DOI":"10.3897\/folmed.64.e60567","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T14:03:58Z","timestamp":1652277838000},"page":"207-213","source":"Crossref","is-referenced-by-count":3,"title":["Pancreatic surface morphology and its classification"],"prefix":"10.3897","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7236-5699","authenticated-orcid":true,"given":"Serghei","family":"Covantev","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Belic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2022,4,30]]},"reference":[{"key":"60567_B1","doi-asserted-by":"crossref","unstructured":"1. Sulochana S, Sivakami T. A gross morphological study of the pancreas in human cadavers. National Journal of Clinical Anatomy 2012; 01(02):55-60.","DOI":"10.1055\/s-0039-3401669"},{"key":"60567_B2","doi-asserted-by":"crossref","unstructured":"2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin 2018; 68(6):394\u2013424.","DOI":"10.3322\/caac.21492"},{"key":"60567_B3","doi-asserted-by":"crossref","unstructured":"3. Dinter D, L\u00f6hr JM, Neff KW. Bifid tail of the pancreas: benign bifurcation anomaly. Am J Roentgenol 2007; 189(5):W251\u2013W3.","DOI":"10.2214\/AJR.05.1453"},{"key":"60567_B4","doi-asserted-by":"crossref","unstructured":"4. Covantev S, Mazuruc N, Belic O. Bifid pancreas tail and superior horizontal pancreatic artery of Popova: an unusual duet. Russ Open Med J 2018; 7:e0203.","DOI":"10.15275\/rusomj.2018.0203"},{"key":"60567_B5","doi-asserted-by":"crossref","unstructured":"5. Kreel L, Sandin B. Changes in pancreatic morphology associated with aging. Gut 1973; 14(12):962\u201370.","DOI":"10.1136\/gut.14.12.962"},{"key":"60567_B6","doi-asserted-by":"crossref","unstructured":"6. Kreel L, Sandin B, Slavin G. Pancreatic morphology--a combined radiological and pathological study. Clinical radiology 1973; 24(2):154\u201361.","DOI":"10.1016\/S0009-9260(73)80074-1"},{"key":"60567_B7","doi-asserted-by":"crossref","unstructured":"7. Kaza RK, Al-Hawary MM, Sokhandon F, et al. Pitfalls in pancreatic imaging. Semin Roentgenol 2015; 50(4):320\u20137.","DOI":"10.1053\/j.ro.2015.08.001"},{"key":"60567_B8","doi-asserted-by":"crossref","unstructured":"8. Mazuruc N, Covantev S, Belic O. A case of unusual vascularization of upper abdominal cavity\u2019 organs. Case Reports in Vascular Medicine 2018; 2018:5738037.","DOI":"10.1155\/2018\/5738037"},{"key":"60567_B9","doi-asserted-by":"crossref","unstructured":"9. Chaudhary V, Bano S. Imaging of the pancreas: Recent advances. Indian J Endocrinol Metab 2011; 15(Suppl 1):S25\u2013S32.","DOI":"10.4103\/2230-8210.83060"},{"key":"60567_B10","doi-asserted-by":"crossref","unstructured":"10. Borghei P, Sokhandon F, Shirkhoda A, et al. Anomalies, anatomic variants, and sources of diagnostic pitfalls in pancreatic imaging. Radiology 2013; 266(1):28\u201336.","DOI":"10.1148\/radiol.12112469"},{"key":"60567_B11","doi-asserted-by":"crossref","unstructured":"11. Kim SS, Shin HC, Hwang JA. Various congenital abnormalities and anatomic variants of the pancreas: a pictorial review. J Belg Soc Radiol 2019; 103(1):39.","DOI":"10.5334\/jbsr.1780"},{"key":"60567_B12","doi-asserted-by":"crossref","unstructured":"12. Yu J, Turner MA, Fulcher AS, et al. Congenital anomalies and normal variants of the pancreaticobiliary tract and the pancreas in adults: part 2, Pancreatic duct and pancreas. AJR 2006; 187(6):1544\u201353.","DOI":"10.2214\/AJR.05.0774"},{"key":"60567_B13","doi-asserted-by":"crossref","unstructured":"13. T\u00fcrkvatan A, Erden A, T\u00fcrko\u011flu MA, et al. Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol 2013; 14(6):905\u201313.","DOI":"10.3348\/kjr.2013.14.6.905"},{"key":"60567_B14","unstructured":"14. Kozu T, Suda K, Toki F. Development of pancreas and biliary duct. In: DiMarino Jr AJ, Benjamin S, editors. Gastrointestinal disease: An Endoscopic Approach. 2nd ed. USA: Slack Incorporated; 2002."},{"key":"60567_B15","unstructured":"15. Gore RM. Normal anatomy and examination techniques. In: Textbook of Gastrointestinal Radiology. 1st ed. Vol. 2. Philadelphia: WB Saunders; 1994. p. 2096\u2013105."},{"key":"60567_B16","unstructured":"16. Mulholland MW, Simeone DM. Pancreas: Anatomy and Structural Anomalies. In: Textbook of Gastroenterology. 3rd ed. Vol. 1. Philadelphia: Williams & Wilkins; 1999. p. 2109\u201317"},{"key":"60567_B17","unstructured":"17. Anacker H. Radiological Anatomy of the Pancreas. In: Anacker H, editor. Efficiency and limits of radiological examination of the pancreas. Stuttgart: Thieme; 1975."},{"key":"60567_B18","doi-asserted-by":"crossref","unstructured":"18. G\u00fc\u00e7l\u00fc M, Serin E, Ulucan S, et al. Agenesis of the dorsal pancreas in a patient with recurrent acute pancreatitis: case report and review. Gastrointestinal endoscopy 2004; 60(3):472\u20135.","DOI":"10.1016\/S0016-5107(04)01733-X"},{"key":"60567_B19","unstructured":"19. Sirli R, Sporea I. Ultrasound examination of the normal pancreas. Med Ultrason 2010; 12(1):62\u20135."},{"key":"60567_B20","doi-asserted-by":"crossref","unstructured":"20. Tran T, Sundaram CP, Bahler CD, et al. Correcting the shrinkage effects of formalin fixation and tissue processing for renal tumors: toward standardization of pathological reporting of tumor size. J Cancer 2015; 6(8):759\u201366.","DOI":"10.7150\/jca.12094"},{"key":"60567_B21","doi-asserted-by":"crossref","unstructured":"21. Copper JE, Budgeon LR, Foutz CA, et al. Comparative analysis of fixation and embedding techniques for optimized histological preparation of zebrafish. Comp Biochem. Physiol C Toxicol Pharmacol 2018; 208:38\u201346.","DOI":"10.1016\/j.cbpc.2017.11.003"},{"key":"60567_B22","doi-asserted-by":"crossref","unstructured":"22. Brandon JC, Izenberg SD, Fields PA, et al. Pancreatic clefts caused by penetrating vessels: a potential diagnostic pitfall for pancreatic fracture on CT. Emerg Radiol 2000; 7(5):283\u20136.","DOI":"10.1007\/PL00011842"},{"key":"60567_B23","doi-asserted-by":"crossref","unstructured":"23. Cleaver O, Dor Y. Vascular instruction of pancreas development. Development (Cambridge, England) 2012; 139(16):2833\u201343.","DOI":"10.1242\/dev.065953"},{"key":"60567_B24","doi-asserted-by":"crossref","unstructured":"24. Villasenor A, Cleaver O. Crosstalk between the developing pancreas and its blood vessels: an evolving dialog. Semin Cell Dev Biol 2012; 23(6):685\u201392.","DOI":"10.1016\/j.semcdb.2012.06.003"},{"key":"60567_B25","doi-asserted-by":"crossref","unstructured":"25. Covantev S, Mazuruc N, Belic O. The arterial supply of the distal part of the pancreas. Surg Res Pract 2019; 2019:5804047.","DOI":"10.1155\/2019\/5804047"},{"key":"60567_B26","doi-asserted-by":"crossref","unstructured":"26. Ross BA, Jeffrey Jr RB, Mindelzun RE. Normal variations in the lateral contour of the head and neck of the pancreas mimicking neoplasm: evaluation with dual-phase helical CT. AJR 1996; 166(4):799\u2013801.","DOI":"10.2214\/ajr.166.4.8610553"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/60567\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/60567\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=60567&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T14:04:07Z","timestamp":1652277847000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/60567\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,30]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,4,30]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.64.e60567","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4,30]]}}}