Embryology - GIT
OUTLINE
Introduction to alimentary tract embryology
a. Primitive Gut
b. Mesenteries
II. Foregut
a. Esophagus
b. Stomach
c. Duodenum
d. Liver and Gallbladder
e. Pancreas
f. Abnormalities of the foregut
III. Midgut
a. Abnormalities of the midgut
IV. Hindgut
a. Abnormalities of the hindgut
I.
*In Times New Roman are information lifted from the book / some other
source
Objectives:
To understand the embryologic development of the alimentary tract and
associated organs
1st month
A. PRIMITIVE GUT
Pharyngeal gut: buccopharyngeal membrane lung bud
Foregut: caudal to pharyngeal tube liver bud
Midgut: caudal to the liver bud to the junction of posterior
(right) 2/3 and distal (left) 1/3 of transverse colon
Hindgut: left 1/3 of transverse colon cloacal membrane
B. MESENTERIES
Suspends the primitive duct
Double layers of peritoneum
Retroperitoneal organs:
o Situated behind the peritoneum
o Covered only in its anterior surface by peritoneum
o Ex: kidneys and pancreas (originally intraperitoneal)
Peritoneal ligaments:
o Pathways for vessels, nerves and lymphatics to and from
abdominal structures
o Ex. Lesser omentum and falciform ligament
o Runs from 1 organ to another / from an organ to the body wall
Dorsal mesentery:
o Extends from lower end of esophagus to cloacal region
o Region of stomach: dorsal mesogastrium or greater omentum
o Duodenum: dorsal dorsal mesoduodenum
o Jejuno-ileal loops: mesentery proper
o Large intestines: dorsal mesocolon
o Serve as pathways
o Supplied by branches of the superior mesenteric artery and
vitiline artery
o Hindgut: inferior mesenteric artery
Ventral mesentery:
o Extends from distal part of esophagus to upper part of
duodenum (covering stomach)
o Arose from a mesodermal plate = septum transversum
(separates the pericardial cavity from the yolk stalk)
o Growth of liver into septum transversum separation into:
visceral peritoneum of liver
lesser omentum (from course of ventral mesentery to liver)
falciform ligament (from ventral body wall to liver)
II. FOREGUT
A. ESOPHAGUS
Initially, the esophagus is short but due to descent of heart and
lungs = elongation
o Upper 2/3: muscular coat, striated innervated by vagus nerve
o Lower 1/3: smooth muscle, innervated by splanchnic plexus
During development: lateral pinching of space between the future
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CLINICAL CORRELATION
Esophageal Atresia with or without tracheoesophageal fistula
Failure of the esophagus to develop completely
May be due to posterior deviation of tracheoesophageal
septum or may be due to a mechanical factor pushing
dorsal portion of the foregut forward
B. STOMACH
Change in position due to rotation of stomach along a longitudinal
axis and an antero-posterior axis due to difference in growth rates
of various parts of the wall of the stomach and in changes in
position of surrounding organs
O
90 clockwise rotation along longitudinal axis:
o Original left side of stomach becomes anterior
o Right side becomes posterior
o Left vagus nerve: anterior part of stomach
o Right vagus nerve: posterior part of the stomach
o Rapid elongation of the original posterior part of the stomach
= greater and lesser curvatures of the stomach
Initially the stomach lies along the midline but due to anteroposterior axis = caudal (pyloric) end shifts towards the right and
upward
Cephalic (cardiac) portion of stomach shifts to the left and slightly
downward
Ventral Mesogastrium
o Liver chords penetrate and increase in number in septum
transversum liver size increases transverse septum
becomes membranous ligament
o Free margin of falciform ligament umbilical vein round
ligament of the liver (ligamentum teres hepatis)
o Free margin of lesser omentum hepatoduodenal ligament
(where portal triad is located bile duct, hepatic artery and
portal vein)
Hepatoduodenal ligament: roof of epiploic foramen of
Winslow (connects greater peritoneal sac and lesser
peritoneal sac)
C. DUODENUM
Upper part: foregut
Lower part: midgut
Initially: midline but due to rotation of stomach takes a C
shaped loop due also to rapid growth of the head of the pancreas
shifts to the right
Dorsal mesoduodenum: disappears (except duodenal cap)
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E. PANCREAS
Forms as 2 endodermal buds from the endodermal lining of the
duodenum
Ventral pancreatic bud: close to the bile duct
o Rotation of the duodenum = pancreatic bud together with bile
duct shifts to the right and rotates with duodenum so
ventral pancreatic bud lies immediately below and behind
dorsal pancreatic bud parenchyma and duct system of the 2
buds will fuse
o Gives rise to the head of the pancreas
Dorsal pancreatic bud: arises from dorsal aspect of duodenum
and lies within the dorsal mesoduodenum
o Gives rise to the rest of the pancreas
Dorsal pancreatic duct (distal) + entire ventral pancreatic duct =
Main pancreatic duct of Wirsung enters duodenum at major
duodenal papilla
Proximal part of pancreatic duct will either obliterate or be
retained.
o If retained, it becomes a small channel known as the accessory
pancreatic duct of Santorini which opens into the minimal
duodenal papilla
rd
3 month: Pancreatic islets of Langerhans are produced
th
5 month: insulin is produced
III. MIDGUT
Suspended in the abdominal cavity by short dorsal mesentery
Apex of primary intestinal loop will open into the yolk sac through
vitelline duct or yolk stalk
Extends from just below the liver bud in duodenum and extends
to the junction of the transverse colon (proximal 2/3 and distal
1/3)
Supplied by the superior mesenteric artery
Characterized by rapid elongation of the gut in the mesentery =
primary intestinal loop: cephalic and caudal
o Cephalic: give rise to most of the SI
Forms lower part of duodenum, jejunum and ileum
During this rotation (primary intestinal loop rotates along
an axis formed by superior mesenteric artery) rapid
increase in length leads to the formation of coils (LI will
not participate in coiling phenomenon)
o Caudal: gives rise to the rest of ileum, cecum and appendix,
ascending colon and proximal 2/3 of the transverse colon
O
o Normally should rotate at 270 counter clockwise
6th week: intestinal loops herniate into the umbilicus = primary
O
intestinal loop should rotate 90 clockwise
O
Up to 10th week, it should turn 180 more before it returns to the
abdominal cavity = thats why the transverse colon is anterior to
duodenum
CLINICAL CORRELATION
Physiological Umbilical Herniation
Last part to enter is the cecal bud which settles in the right
upper quadrant then begins forming the appendix
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CLINICAL CORRELATION
Problems with the Hindgut
Imperforated Anus
12 week of gestation
Failure of relaxation
Rectosigmoid (site)
Ostomy / colostomy
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