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Development of the Gastrointestinal Tract

Professor Mahmoud M.S Abu-KhalafDepartment of Surgery

Faculty of Medicine &Jordan University Hospital

University of Jordan Amman-Jordan

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Reference

Larsen’s Human Embryology Gary C. SchoenwolfSteven B. BleylPhilip R. BrauerPhilipia H. Francis-West

ElsevierChurchillLivingstone

2008

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Body Folding

The endodermal gut tube (primary guttube) created by body folding during the4 th week, consists of a :

Blind-ended cranial foregutBlind-ended caudal hindgut; and a midgutopen to yolk-sac through the vitelline duct

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Derivatives of the Primary Gut TubeRegions of differentiated Gut tube Accessory organs derived from gut tube endoderm

Foregut

Pharynx Pharyngeal Pouch derivativesThoracic esophagus Lungs

Abdominal esophagus

Stomach

Superior half of duodenum (superior to ampullaof pancreatic duct)

Liver parenchyma and hepatic duct epithelium gallbladder,cystic duct, and common bile duct dorsal and ventralpancreatic buds (exocrine cells, endocrine and pancreaticductal cells)

Midgut

Inferior half of duodenum

jejunum

Ilieum

Cecum Appendix

Right two thirds of transverse colon

Hindgut

Left one third of transverse colon

Descending colon

Sigmoid colon

rectum Uro enital sinus and derivatives

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Dorsal Mesentery Initially Suspends Abdominal Gut TubeFormation of the dorsal Mesentery

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Peritoneal CavityIntraperitoneal visceraRetroperitoneal organs

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Secondary Retroperitoneal OrgansVentral Mesentery

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Three Regions Of The PrimitiveGut

ForegutPharynx and thoracic oesophagus five aortic branches

Abdominal oesophagus celiac trunk

Midgut Superior Mesenteric Artery

Hindgut Inferior Mesenteric Artery

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Endo-dermal lining of primary gut tube

becomes surrounded by cells derived fromlateral plate splanchnic mesoderm; whichcondenses and differentiate into the:

Lamina propriaSubmucosaMuscular wallVascular elementsConnective tissues of the GIT and organs.

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Development of the abdominal Foregut

Formation and rotation of the stomachFusion shapeGreater and lesser curve, fundus, cardia.90 degree rotation around its craniocaudalaxixDorsal mesogastrium

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Peritoneum

Lesser sac

Greater sac

Greater Omentum

Upper recess

Lower recess

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Development of Liver anGallbladder

Hepatic plate hepatic diverticulumHepatoblasts hepatocytes, bilecanaliculi, hepatic duct.Mesoplastic support stroma develops from

Septum transversumSplanchnic mesoderm

Endothelial precursor cells of unknown origin

Sinusoidal endothelium

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Cystic diverticulumCystic duct

GallbladderCommon bile duct

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Development of the Pancreas

Dorsal pancreatic budVentral pancreatic bud

Ventral pancreatic bud becomesconnected to proximal end of the CBD

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Ventral pancreatic duct

Migrate posteriorly around the duodenum towardthe dorsal mesenteryFusion of the ventral and dorsal pancreatic buds

Fusion of the pancreas to the dorsal body wall

Secondarily retroperitoneum

Interconnection of the ductal system of the twobuds.Degeneration of the duct connecting the dorsalbud to the duodenum.

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Dorsal bud: gives rise to the head, body and tailof the pancreasVentral bud: gives rise to the uncinateMain pancreatic duct

Dorsal pancreatic duct, interconnecting duct, ventralpancreatic duct.Main pancreatic duct meets CBD and enties into theduodenum at the major duodenal papilla or theampulla of vater.In some individuals, the dorsal duct persists as theaccessory pancreatic duct that empties in the minorduodenal papilla

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Abnormal Formation And Rotation OfVentral Pancreas

Ventral pancreatic bud

Bilobed and each lobe migrates inopposite direction around the pancreas tofuse with the dorsal bud.

Annular pancreas compresses theduodenum and may cause duodenalstenosis.

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Pancreatic divisum (non-fusion)

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Cell Types Derived From Pancreatic Ectoderm

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Formation Of Tubular Glands

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Development of the spleen

The spleen is mesodermal derivative, nota product of the gut tube endoderm

A mesenchymal condensation Accessory spleensLieno-renal ligament gastrosplenicligament

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Derivatives Of The Ventral Mesentery

Septum transversumVisceral peritoneum on surface of liverBare area of liver

Coronary ligamentsFalciform ligamentLesser omentumHepatogastric ligamentHepatoduodenal ligamentEpiploic foramen of winslow

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Development of Midgut

Primary intestinal loop

Herniation and rotation of the intestine

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Rotation Defects of the MidgutNon-Rotation of the Midgut

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Reversed Rotation of the Midgut

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Mixed Rotation of the gut

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Volvulus Of Intestine

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Defects of the umbilicus and anteriorabdominal wall

Meckel’s diverticulum Omphalomesenteric fistula

Omphalomesenteric cyst or (enterocyst)Omphalomesenteric ligament or (fibrousband)

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Umbilical HerniaOmphalocele

Gastroschisis

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Cytodifferentiation of endodermalepithelium of gut

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