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Development of GI system

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Presentation on theme: "Development of GI system"— Presentation transcript:

1 Development of GI system
陳建榮

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3 GI system: Primitive Gut Morphogenesis Foregut Midgut Hindgut
Foregut embryology Midgut embryology Hindgut embryology 

4 Formation of primitive gut
Head fold, tail fold and lateral fold Foregut Midgut Hindgut

5 Primitive gut:

6  The primitive gut: Foregut 前腸 esophagus stomach(S) proximal half of the duodenum (PD), liver and pancreas. Midgut 中腸 distal half of the duodenum(DD) jejunum(J), ileum(I), cecum(C), appendix, ascending colon and the right 3/4 of the transverse colon. Hindgut 後腸 left 1/4 of the transverse colon the descending colon sigmoid colon the rectum(R) down to the ano-rectal line (the endoderm-ectoderm junction).

7 The venous drainage of the gut :
The blood supply: Foregut : celiac artery Midgut :superior mesenteric artery Hindgut :inferior mesenteric artery The venous drainage of the gut : Foregut : portal vein Midgut : superior mesenteric vein Hindgut :inferior mesenteric vein.

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9 Functional divisions of primitive GI system
ARTERY VEIN LYMPHATICS SYMPATHETIC PARASYMPATHETIC FOREGUT: Esophagus Stomach Proximal half of duodenum (up to common bile duct (CBD)) Liver Pancreas CELIAC ARETERY PORTAL VEIN Spleenic vein Gastric vein CELIAC NODES CELIAC GANGLIA VAGUS MIDGUT: Distal half of duodenum (from CBD) Jejunum Ileum Appendix Cecum Ascending colon Right 3/4 of transverse colon SUPERIOR MESENTERIC ARTERY SUPERIOR MESENTERIC VEIN SUPERIOR MESENTERIC NODES SUPERIOR MESENTERIC GANGLIA HINDGUT: Left 1/4 of transverse colon Descending colon All of rectum down to ano-rectal line INFERIOR MESENTERIC ARTERY INFERIOR MESENTERIC VEIN INFERIOR MESENTERIC NODES GANGLIA HYPOGASTRIC PLEXUS PELVIC SPLANCHNIC NERVES

10 GI system: Primitive Gut Morphogenesis Foregut Embryology
Development of stomach Development of mesentery Liver morphogenesis Pancrease morphogenesis Midgut embryology Hindgut embryology 

11 Development of stomach
Clock wise 90 Greater curvature of stomach胃大彎 Lesser curvature of stomach胃小彎 Vagus n.

12 Development of stomach

13 Development of stomach

14 GI system: Primitive Gut Morphogenesis Mesentery morphogenesis
Dorsal mesentery背總腸繫膜 Ventral mesentery腹總腸繫膜 Foregut Embryology Midgut embryology Hindgut embryology 

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16 Formation of Greater omentum大網膜

17 網膜孔 網膜囊

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26 THE MESENTERY: -ventral mesentery:
-falciform lig.鐮狀韌帶 -lesser omentum小網膜 -coronary lig.冠狀韌帶 -triangular lig.三角韌帶 -dorsal mesentery: Mesogastrium : greater omentum大網膜, omentum bursa網膜囊 Mesoduodenum十二指膜系膜 mesentery proper (distal duodenum, jejunum and ileum), mesocolon 結腸系膜 Mesorectum直腸系膜

27 Development of liver: 4 weeks 5 weeks Hepatic diverticulum肝憩室
Hepatic cords 肝索 Gallbladder膽囊 Ventral pancreatic bud腹側胰芽 5 weeks 6 weeks

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29 Development of pancrease
Dorsal pancreatic bud背側胰芽 Body and tail of pancrease, accessory pancreatic duct Ventral pancreatic bud腹側胰芽 Uncinate process of pancrase, main pancreatic duct

30 Clinical problems Annular pancrease環狀胰臟

31 Duodenal stenosis or atresia十二指腸栓塞或狹窄

32 Development of spleen Accessory spleen副脾

33 GI system: Primitive Gut Morphogenesis Foregut Embryology
Midgut embryology Rotation of midgut loop Retum of midgut to abdomen Fixation of intestine Cecum and appendix Hindgut embryology 

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36 Rotation of midgut loop
6 weeks Rotation of midgut loop - Counterclock wise 90 10 weeks Retum of midgut to abdomen 11 weeks

37 Midgut development of animals

38 Midgut development of animals

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40 Clinical problems Umbilical hernia ↑ ↓ Gastroschisis
Muscles of abdominal wall : normal

41 Gastroschisis 裂腹畸形(前腹壁缺損)

42 Nonrotation of midgut Mixed rotation and volvulus Reversed rotation Internal hernia Midgut volvulus

43 Fixation of intestine

44 Cecum and appendix

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46 Clinical problems Meckel’s diverticulum梅爾氏憩室

47 Ileal diverticulum迴腸憩室

48 Duplication of intestine腸重覆

49 GI system: Primitive Gut Morphogenesis Foregut Embryology
Midgut embryology Hindgut embryology  Partitioning of cloaca泄殖腔 Urorectal septum泌尿直腸隔 Cloaca泄殖腔 Urogenital sinus泌尿生殖竇 Anal canal肛管

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52 Partition of cloaca

53 Anal canal 恥狀線 原肛

54 Clinical problems 直腸尿道瘻管 直腸陰道瘻管 肛門會陰瘻管 Type I Type II Type III Type IV

55 Membranous atresia of anal
Rectovaginal fistula Rectourethral fistula 直腸陰道瘻管 直腸尿道瘻管

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