M1207 – Gastrointestinal System

Embryology lecture

Development of the
Gastrointestinal System - IV

Dr. Sampath Paththinige

MBBS, MSc, PGCert(MedEd)
Department of Anatomy
Faculty of Medicine & Allied Sciences
Rajarata University of Sri Lanka
 Objectives
At the end of the lecture, students should be able to,
1. state the derivatives of embryonic hindgut
2. describe fate of cloaca
3. describe the development of the anal canal
4. state the embryological basis of the following anorectal
anomalies
– Imperforate anus
– Rectourethral/ rectovaginal fistula
– Congenital aganglionic megacolon/ Hirschprung disease
 Hindgut
 Begins at the junction of the proximal two-thirds of the
transverse colon with the distal third
 Ends at the cloaca
Midgut loop
 Derivatives of Hindgut
 Distal 1/3 of transverse colon
 Descending colon Appendix
 Sigmoid colon Urachus
Developing bladder
 Rectum HINDGUT

 Upper part of anal canal CLOACA

 Bladder and urethra Developing ureter

 Fate of cloacal region

Cloaca is a common
opening for digestive,
urinary and reproductive
systems during early
development

 Hindgut opens into

posterior region of
cloaca
 Allantois opens into
anterior region
 Cloaca is covered by
cloacal membrane
 A mesodermal layer
known as urorectal
septum divides the
cloaca into
– Anorectal canal
(Posterior)
– Urogenital sinus
(Anterior)
 Cloacal membrane
ruptures
 Urogenital sinus
develops into bladder
and urethra
 Outgrowth from the
urogenital sinus known as
Sinovaginal bulbs form
the lower part of the
vagina in females
 Tip of the urorectal
septum becomes the
perineal body
 Opening of the anorectal
canal gets covered by an
ectodermal proliferation
(Anal membrane)
Development of the
anal canal Anorectal canal
(Endoderm)
 Ectodermal plug (anal
Anal membrane
membrane) recanalizes; (Ectoderm)
creating anal canal and
anus
 Anal canal originates
from both endoderm
(upper part) and Rectum
ectoderm (lower part)

Anal canal
Dentate line (Pectinate line) represents the junction between
endoderm and ectoderm
Rectosigmoid junction

Sigmoid colon

Rectum
Transverse rectal folds
(rectal valves of Houston)

Anorectal ring

Surgical
Anatomical
anal canal
anal canal
Anal verge Pectinate line/ dentate line
 Clinical correlates - Anorectal malformations

1. Imperforate anus
– No anal opening: Due to lack of recanalization of the
ectodermal plug (anal membrane)
Clinical correlates : Anorectal malformations
Clinical correlates - Anorectal malformations

2. Opening of the hindgut

into abnormal sites
– Into urethra
: Recto-urethral fistula 
causes fecal discharge
through the urethral opening

– Into vagina:
: Recto-vaginal fistula
– Into skin at abnormal site:
: Recto-cutaneous fistula 
• A 3 day old baby was referred to the consultant paediatric
surgeon due to abdominal distension and bile stained vomiting

• The baby has not passed stools (meconium) after birth

• The examination
of the abdomen
revealed gaseous
distension of the
abdomen.
The anal opening
was present.
The barium enema
performed in this baby
shows
• Narrowed sigmoid
colon
• Grossly distended
ascending, transverse
and descending parts
of the colon

What is the most

probable diagnosis?
 Clinical correlates - Anorectal malformations

3. Congenital aganglionic megacolon /

Hirschsprung disease
– Absence of parasympathetic ganglia (derived from neural crest
cells) in intestinal nerve plexuses

– Commonly affects the

recto-sigmoid region of colon
– Affected segment fails to relax
– Part proximal to the narrowed
affected segment gets distended
Sampath