Development of Gastrointestinal System

(Laboratory Introduction)

Siska Nia Irasanti,drg

Fakultas Kedokteran
Universitas Islam Bandung
2013
As a result of cephalocaudal and lateral folding of the embryo, a portion of the endoderm-lined yolk sac cavity is
incorporated into the embryo to form the primitive gut.

Development of the primitive gut and its derivatives :

(a) The foregut lies caudal to the pharyngeal tube and extends as far caudally as the liver outgrowth.
(b) The midgut begins caudal to the liver bud and extends to the junction of the right two-thirds and left third of
the transverse colon in the adult.
(c) The hindgut extends from the left third of the transverse colon to the cloacal membrane
 Organogenesis of digestive system
Endoderm forms the epithelial lining of the digestive tract & parenchyma of
glands, such as the liver and pancreas.
Splanchnic mesoderm Muscle, connective tissue, and peritoneal
components of the wall of the gut.

Primitive gut foregut, midgut, and hindgut.

Fore gut Primordial pharynx and its derivatives, Esophagus and
stomach, duodenum(distal to the opening of the duct, liver, billiary app
(hepatic ducts, gallblader and bile duct), pancreas
Midgut Small intestine including the duodenum distal to the opening of
the bile duct, Caecum, appendix, ascending colon, the right one half to
two thirds of the transverse
Hind gut The left of one third to one half of the transverse colon,
descending colon, sigmoid colon, rectum, the superior part of the anal
canal
Organogenesis of digestive system
Primitive gut : foregut, midgut, and hindgut.
The esophagus : foregut
Stomach : dilatation of the foregut, rotation of
the greater and lesser curvatures, and pyloric and
cardiac portion.
Duodenum : portions of intestinal tract, hepatic
diverticulum, and pancreatic bud.
Intestinal loop : jejunum, ileum, caecum,
appendix, colon and rectum, in the process of
retraction of herniated loop, and rotation and
fixation of the intestinal loop.
 Esophagus
Embryo 4 weeks old, the respiratory diverticulum (lung bud) appears at the
ventral wall of the foregut at the border with the pharyngeal gut.
The tracheoesophageal septum gradually partitions this diverticulum from the
dorsal part of the foregut.
The foregut divides : a ventral portionrespiratory primordium
dorsal portion esophagus .
At first the esophagus is short , but with descent of the heart and lungs it lengthens
rapidly .
The muscular coat striated in its upper two-thirds
the muscle coat is smooth in the lower third
Esophageal abnormality
 Stomach
4th week a fusiform dilation of the foregut position change greatly regions of its wall and
the changes in position of surrounding organs.
The stomach rotates 90 clockwise - longitudinal axisleft side to face anteriorly and its right side
to face posteriorly
During this rotation the original posterior wall of the stomach grows faster than the anterior
portion, forming the greater and lesser curvatures
The stomach also rotates around an anteroposterior axis, such that the caudal or pyloric part
moves to the right and upward and the cephalic or cardiac portion moves to the left and slightly
downward final position its axis running from above left to below right.
 Stomach abnormalities
Pyloric stenosis occurs when the circular and, to a
lesser degree, the longitudinal musculature of the
stomach in the region of the pylorus hypertrophies.
One of the most common abnormalities of the
stomach in infants, pyloric stenosis is believed to
develop during fetal life. There is an extreme narrowing
of the pyloric lumen, and the passage of food is
obstructed, resulting in severe vomiting. In a few cases
the pylorus is atretic.
Other malformations of the stomach, such as
duplications and a prepyloric septum, are rare.
 Duodenum
Duodenum : portions of intestinal tract, hepatic diverticulum, and
pancreatic bud.
The terminal part of the foregut and the cephalic part of the midgut
duodenum.
The junction of the two parts is directly distal to the origin of the liver bud
As the stomach rotates, the duodenum takes on the form of a C-shaped
loop and rotates to the right together with rapid growth of the head of
the pancreas swings the duodenum from its initial midline position to
the left side of the abdominal cavity .
The duodenum and head of the pancreas press against the dorsal body wall, and the right surface
of the dorsal mesoduodenum fuses with the adjacent peritoneum. Both layers subsequently
disappear, and the duodenum and head of the pancreas become fixed in a retroperitoneal
position. The dorsal mesoduodenum disappears entirely except in the region of the pylorus of
the stomach, where a small portion of the duodenum (duodenal cap) retains its mesentery and
remains intraperitoneal
During the second month, the lumen of the duodenum
is obliterated by proliferation of cells in itswalls.
However, the lumen is recanalized shortly thereafter
Duodenal abnormalities
 Intestinal loop
Development of the midgut is characterized by rapid elongation of the gut and its mesentery, resulting in
formation of the primary intestinal loop part of the ileum.
The caudal limb becomes the lower portion of the ileum, the cecum, the appendix, the ascending colon, and the
proximal two-thirds of the transverse colon.
and they enter the extraembryonic cavity in the umbilical cord during the sixth week of development
(physiological umbilical herniation)
 Coincident with growth in length, the primary intestinal loop rotates around an
axis formed by the superior mesenteric artery . When viewed from the front, this
rotation is counterclockwise, and it amounts to approximately 270 when it is
complete (Figs. 13.24 and 13.25). Even during rotation,
elongation of the small intestinal loop continues, and the jejunum and ileum form
a number of coiled loops (Fig. 13.26). The large intestine likewise lengthens
considerably but does not participate in the coiling phenomenon. Rotation occurs
during herniation (about 90) as well as during return of the intestinal loops into
the abdominal cavity (remaining 180)
 Reduced growth liver + expansion of abdominal cavity
During the 10th week, herniated intestinal loops
begin to return to the abdominal cavity
Abnormality of Intestinal loop
 The hindgut gives rise to the distal third of the
transverse colon, the descending colon, the
sigmoid, the rectum, and the upper part of
the anal canal. The endoderm of the hindgut
also forms the internal lining of the bladder
and urethra
Thank you
 Teratology of Digestive System
(Congenital Malformation)
1.Foregut :
Esophagus : esophageal atresia, esophageal stenosis, short esophagus.
Stomach : Congenital hypertrophic pyloric stenosis.
Duodenum : Duodenal stenosis, duodenal atresia,
Liver & Biliary Aparatus : anomalies of the liver, ekstrahepatic biliary
atresia.
Pancreas : accessory pancreatic tissue, anular pancreas.
Spleen : accessory spleen.
 Teratology of Digestive System
(Congenital Malformation)
2. Midgut :
Congenital omphalocele
Umbilical hernia
Gastroschisis
Nonrotation of the midgut
Mixed rotation and volvulus
Reversed Rotation
Subhepatic caecum and appendix
Mobile caecum
Internal hernia
Midgut volvulus
Stenosis and atresia of the intestine
Ileal diverticulum and other yolk stalk remnants
Duplication of the intestine
 Teratology of Digestive System
(Congenital Malformation)
3. Hindgut :
Congenital megacolon
Imperforate anus and anorectal anomalies
Anal agenesis, with or without a fistula
Anal stenosis
Membranous atresia of the anus
Anorectal agenesis, with or without a fistula
Rectal atresia