BGDB Gastrointestinal - Activity 2: Difference between revisions
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# Describe the structure of the attachment of the gut to the body wall. | # Describe the structure of the attachment of the gut to the body wall. | ||
# Identify the developmental origins of abnormalities of the gut lumen, innervation, herniation and malrotation. | # Identify the developmental origins of abnormalities of the gut lumen, innervation, herniation and malrotation. | ||
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| [[File:Gray0982a.jpg|The early developing gastrointestinal tract]] | |||
| [[File:Gray0982b.jpg|The later developing gastrointestinal tract]] | |||
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| Early Embryo | |||
| Later Embryo | |||
|} | |||
==1. Mechanical Changes== | ==1. Mechanical Changes== | ||
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Diagnosis is generally by upper gastrointestinal radiologic examination or less frequently by barium enema or CT scan. Corrective surgery is generally by the Ladd's procedure, even with surgical treatment there is still significant associated complications and long-term morbidity. | Diagnosis is generally by upper gastrointestinal radiologic examination or less frequently by barium enema or CT scan. Corrective surgery is generally by the Ladd's procedure, even with surgical treatment there is still significant associated complications and long-term morbidity. | ||
===Hirschsprung disease=== | |||
{{ICD-11}} {{ICD11weblink}}1772690306 LB16.1 Hirschsprung disease] - ''This is a developmental anomaly affecting the intestinal tract characterized by congenital absence of myenteric ganglion cells (aganglionosis) in a segment of the large bowel. Due to the absence of intrinsic innervation of the muscle layers of the affected segment, there is a loss of motor function. This results in an abnormally large or dilated colon (congenital megacolon) with intestinal occlusion or constipation. This condition becomes evident shortly after birth.'' | |||
({{intestinal aganglionosis}}, {{Hirschsprung's disease}}, {{aganglionic colon}}, {{megacolon}}, congenital aganglionic megacolon, congenital megacolon) A condition caused by the lack of enteric nervous system (neural ganglia) in the intestinal tract responsible for gastric motility (peristalsis). In general, its severity is dependent upon the amount of the GIT that lacks intrinsic ganglia, due to developmental lack of neural crest migration into those segments. (More? {{Neural crest abnormalities}}) | |||
{| class="prettytable" | |||
| [[Image:Megacolon_stoma1.jpg]] | |||
| [[Image:Megacolon_stoma2.jpg]] | |||
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| Ostomy - Aganglionic portion removed | |||
| Stoma - intestine attached to the abdomen wall | |||
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|- | |||
| [[File:Megacolon surgery 01.jpg|200px]] | |||
| [[File:Megacolon surgery 02.jpg|200px]] | |||
| [[File:Megacolon surgery 03.jpg|200px]] | |||
|- | |||
| Short section of the colon without smooth muscle neural ganglia | |||
| Aganglionic segment removed | |||
| Reattachment | |||
|} | |||
==Interactive Component== | ==Interactive Component== |
Latest revision as of 14:49, 20 April 2019
Practical 1: Activity 1 | Activity 2 | Activity 3 | Activity 4 |
Learning Activity 2
- Describe how elongation and rotation of the simple primitive tube establish the gut anatomy.
- Explain the developmental processes of elongation, herniation and rotation of the mid-gut.
- Describe the structure of the attachment of the gut to the body wall.
- Identify the developmental origins of abnormalities of the gut lumen, innervation, herniation and malrotation.
Early Embryo | Later Embryo |
1. Mechanical Changes
Transverse section of the developing stomach mid-embryonic period (Week 5 Carnegie stage 13)
<html5media height="820" width="580">File:Stage14 EFIC C01.mp4</html5media> |
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2. Mesentery
3. Mid-Gut
Human Embryo MRI at the end of embryonic development (GA week 10).
Observe:
- midgut herniated at the umbilicus, lying outside the ventral body wall, connected by mesentry
- large liver lying directly under the diaphragm and occupying the entire ventral body cavity with other organs "embedded"
- developing pancreas lying in the loop between stomach and duodenum
<html5media height="550" width="570">File:Stage22_GIT3d.mp4</html5media> |
<html5media height="500" width="500">File:Stage23 MRI S04.mp4</html5media> |
Mid-Gut Rotation/Sliding
Very simplified demonstration of midgut reorganisation to establish adult anatomical positions.
Green ring = ventral body wall Red vessels = superior mesenteric artery
4. Abnormality Origins
Omphalocele
Abdominal wall herniation abnormality occurs in both omphalocele and gastroschisis with different developmental origins. Omphalocele involves "covered by membranes" and a lack of normal return of the bowel to the abdominal cavity and has a different position relative to the umbilical cord.
Gastroschisis
Gastroschisis is a developmental abnormality occurs due to an abdominal wall defect, that allows the evisceration of the intestine.
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Volvulus of small intestine
ICD-11 DA91.1 Volvulus of small intestine - A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vessels and so make the involved loop particularly susceptible to strangulation and gangrene, with resulting perforation, peritonitis, and sepsis.
Diagnosis is generally by upper gastrointestinal radiologic examination or less frequently by barium enema or CT scan. Corrective surgery is generally by the Ladd's procedure, even with surgical treatment there is still significant associated complications and long-term morbidity.
Hirschsprung disease
ICD-11 LB16.1 Hirschsprung disease - This is a developmental anomaly affecting the intestinal tract characterized by congenital absence of myenteric ganglion cells (aganglionosis) in a segment of the large bowel. Due to the absence of intrinsic innervation of the muscle layers of the affected segment, there is a loss of motor function. This results in an abnormally large or dilated colon (congenital megacolon) with intestinal occlusion or constipation. This condition becomes evident shortly after birth.
(intestinal aganglionosis, Hirschsprung's disease, aganglionic colon, megacolon, congenital aganglionic megacolon, congenital megacolon) A condition caused by the lack of enteric nervous system (neural ganglia) in the intestinal tract responsible for gastric motility (peristalsis). In general, its severity is dependent upon the amount of the GIT that lacks intrinsic ganglia, due to developmental lack of neural crest migration into those segments. (More? neural crest abnormalities)
Ostomy - Aganglionic portion removed | Stoma - intestine attached to the abdomen wall | |
Short section of the colon without smooth muscle neural ganglia | Aganglionic segment removed | Reattachment |
Interactive Component
Practical 1: Activity 1 | Activity 2 | Activity 3 | Activity 4 |
Additional Information
Additional Information - Content shown under this heading is not part of the material covered in this class. It is provided for those students who would like to know about some concepts or current research in topics related to the current class page. |
Gastrointestinal Tract Terms | ||
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Cite this page: Hill, M.A. (2024, April 26) Embryology BGDB Gastrointestinal - Activity 2. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/BGDB_Gastrointestinal_-_Activity_2
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G
- ↑ Akakpo-Numado GK, Gnassingbe K, Boume MA, Sakiye KA, Mihluedo-Agbolan K, Attipou K & Tekou H. (2012). Emergency treatment of a ruptured huge omphalocele by simple suture of its membrane. Ann Surg Innov Res , 6, 2. PMID: 22325297 DOI.
- ↑ Feldkamp ML, Carey JC & Sadler TW. (2007). Development of gastroschisis: review of hypotheses, a novel hypothesis, and implications for research. Am. J. Med. Genet. A , 143A, 639-52. PMID: 17230493 DOI.