Embryological Anatomy of the Gastrointestinal Tract

Posted by e-Medical PPT Friday, December 30, 2011
Digestive tract divided into segments based on vascular supply
Foregut (esophagus, stomach, part of duodenum, biliary apparatus): celiac artery
• Midgut (rest of small & large bowel up almost to splenic flexure): superior mesenteric artery
• Hindgut (rest of large bowel to superior part of anal canal): inferior mesenteric artery
Dorsal and ventral mesenteries and their fates
• Ventral mesentery: mostly breaks down, except lesser omentum & falciform ligament
• Dorsal mesentery: mostly retained, forming greater omentum & other named mesenteries

Case Presentation
Choking and continuous coughing were observed in a newborn infant. There was an excessive amount of mucous secretion and saliva in the infant’s mouth, who experienced considerable difficulty in breathing. The pediatrician was unable to pass a catheter through the esophagus into the stomach.Radiography demonstrated air in the infant’s stomach.Esophageal atresia with tracheoesophageal fistula

Case Presentation
A female infant was born prematurely at 32 weeks’ gestation to a 39-year-old woman whose
pregnancy was complicated by polyhydramnios.Amniocentesis at 16 weeks showed that the infant had trisomy 21. The baby began to vomit within a few hours after birth; the vomitus contained bile. Marked dilation of the epigastrium also was noted. Radiographs of thestomach showed gas in the stomach and the superior part of the duodenum, but no other intestinal gas was observed.

Gut Rotation
• Midgut elongates faster than trunk: herniates into umbilical cord in 6th week
• Midgut loop connected to yolk sac via a yolk stalk
• Cranial limb of loop: jejunum and most of ileum
• Caudal limb: distal ileum, cecum, ascending colon, proximal part of transverse colon
• Series of three 90ยบ counterclockwise rotations around the superior mesenteric artery
• Sequential return of the gut to the trunk

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