Digestive

System
MD. MSc. Othman Thaher
 DIVISIONS OF THE GUT TUBE
As a result of cephalocaudal & lateral folding, a portion of the yolk sac
cavity is incorporated into the embryo forming the primitive gut.

•Two other portions, the yolk sac & the allantois, remain outside the
embryo.

•In the cephalic & caudal parts of the embryo, the primitive gut forms a
blind-ending tube, the foregut & hindgut.

•The middle part, the midgut, remains temporally connected to the yolk
sac by the vitelline duct, or yolk stalk.
 DIVISIONS OF THE GUT TUBE
Primitive gut & derivatives discussed in 4 sections:
A. Foregut: pharyngeal gut, or pharynx, extends from the oropharyngeal
membrane to the respiratory diverticulum. The remainder of the foregut lies
caudal to the pharyngeal tube & extends as far as the liver outgrowth.

B. Midgut: begins caudal to the liver bud & extends to the junction of right 2/3 &
left 1/3 of the transverse colon.

C. Hindgut: extends from the left 1/3 of the transverse colon to the cloacal
membrane.
• Endoderm forms the epithelial lining of the digestive tract & gives rise to the
specific cells (the parenchyma) of glands.
• Visceral mesoderm gives the stroma for the glands & gives muscle, connective
tissue & peritoneal components of the wall of the gut.
Cephalocaudal folding
Lateral folding
 MESENTERIES
Double layers of peritoneum enclosing organs & connect it to the body wall.

•Portions of gut tube & its derivatives are suspended from the dorsal & ventral body wall by
mesenteries such organs called intraperitoneal.

•Organs that lie against the posterior body wall & are covered by peritoneum on their anterior
surface only (e.g., the kidneys) are considered retroperitoneal.

•Mesenteries & ligaments provide pathways for vessels, nerves, & lymphatics to & from
abdominal viscera.
 MESENTERIES
Initially the foregut, midgut, & hindgut are in broad contact with the
posterior abdominal wall.

•By 5th week, the connecting tissue has narrowed & the caudal part of
the foregut, midgut & major part of hindgut are suspended from the
abdominal wall by the dorsal mesentery.

• In the region of the stomach, it forms the dorsal mesogastrium or

greater omentum.
• Duodenum, it forms the dorsal mesoduodenum.
• Jejunal & ileal loops forms the mesentery proper.
• Colon, it forms the dorsal mesocolon.
 MESENTERIES
Ventral mesentery which exists only in the region of the terminal part of
the esophagus, the stomach & the upper part of the duodenum is
derived from the septum transversum.

Growth of the liver into the septum transversum divides the ventral
mesentery into:
(a) The lesser omentum, extending from the lower portion of the
esophagus, the stomach & the upper portion of the duodenum to the
liver.
(b) The falciform ligament, extending from the liver to the ventral body
wall.
Esophagus
 At 4 weeks, the respiratory diverticulum appears at the ventral wall
of the foregut.
 The tracheoesophageal septum gradually partitions this
diverticulum from the dorsal part of the foregut.
 In this manner, the foregut divides into ventral portion, respiratory
primordium, & dorsal portion, the esophagus.
 At first, the esophagus is short, but with descent of heart & lungs, it
lengthens.
The muscular coat, is formed by surrounding splanchnic mesenchyme.
Upper 2/3 is striated & innervated by the vagus.
Lower 1/3 is smooth & innervated by the splanchnic plexus.
Respiratory diverticulum and its separation
from the foregut
Stomach
• Appears as a fusiform dilation of the foregut in the 4th week.

• Its appearance & position change greatly as a result of the different rates of growth in various
regions of its wall & changes in position of surrounding organs.

• The stomach rotates 90°clockwise around its longitudinal axis, causing its left side facing
anteriorly & its right side facing posteriorly. So, the left vagus nerve innervates anterior wall
and the right nerve innervates its posterior wall.

• The greater & lesser curvatures are formed due to the faster growth of the original posterior
wall of the stomach than the anterior portion.

• During further growth, the stomach rotates around an anteroposterior axis, such that the
caudal or pyloric part moves to the right & upward, & the cephalic or cardiac portion moves to
the left & slightly downward.
The stomach assumes its final position, its axis running from above left to below right
Stomach
• Rotation about the longitudinal axis pulls:
The dorsal mesogastrium to the left, creating a space behind the stomach called
the omental bursa (lesser peritoneal sac).
Ventral mesogastrium to the right.

o The spleen primordium appears as a mesodermal proliferation between the two

leaves of dorsal mesogastrium.
o The dorsal mesogastrium lengthens & the portion between the spleen & dorsal
midline swings to the left & fuses with the peritoneum of posterior abdominal
wall.
o The spleen, remains intraperitoneal, connected to the body wall in the region of
the left kidney by the lienorenal ligament & to the stomach by the gastrolienal
ligament.
Dorsal and ventral mesogastrium
Stomach
• Initially, the pancreas grows into the dorsal mesoduodenum, but
eventually its tail extends into the dorsal mesogastrium.

• Since this portion of the dorsal mesogastrium fuses with the dorsal
body wall, the tail of the pancreas lies against this region.

• Once the posterior leaf of the dorsal mesogastrium & the peritoneum
of the posterior body wall degenerate along the line of fusion, the tail
of the pancreas is covered by peritoneum on its anterior surface only
& therefore lies in a retroperitoneal position. (Organs that are
originally covered by peritoneum, but later becomes retroperitoneal,
are said to be (secondarily retroperitoneal).
Formation of the lesser sac
Stomach
• As a result of rotation of the stomach about its anteroposterior axis,
the dorsal mesogastrium bulges down. It continues to grow down &
forms a double-layered sac extending over the transverse colon &
small intestinal loops like an apron.

• This double-leafed apron is the greater omentum; later, its layers fuse
to form a single sheet hanging from the greater curvature of the
stomach.

• The posterior layer of the greater omentum also fuses with the
mesentery of the transverse colon.
Formation of the greater omentum
Stomach
• The lesser omentum & falciform ligament are formed from ventral
mesogastrium, which itself is derived from mesoderm of the septum
transversum.

• liver cords grow into the septum, forming:

A. The peritoneum of the liver.
B. The falciform ligament.
C. The lesser omentum.

• The free margin of the falciform ligament contains the umbilical vein which is
obliterated after birth to form the round ligament of liver.
• The free margin of the lesser omentum connecting the duodenum & liver
(hepatoduodenal ligament) contains the bile duct, portal vein, & hepatic artery
Lesser omentum and falciform ligament
Duodenum
• Formed from the terminal part of the foregut & the cephalic part of the midgut.
• The junction of the two parts is directly distal to the origin of the liver bud.
• The duodenum takes a C-shaped loop & rotates to the right as the stomach
rotates.
• The duodenum & head of the pancreas press against the dorsal body wall & the
right surface of the dorsal mesoduodenum fuses with the adjacent peritoneum.
• Both layers subsequently disappear & the duodenum & head of the pancreas
become fixed in a retroperitoneal position. The entire pancreas thus obtains a
retroperitoneal position.
Duodenum
• The dorsal mesoduodenum disappears entirely
exceptin the region of the pylorus of the stomach,
where a small portion of the duodenum (duodenal
cap) retains its mesentery & remains intraperitoneal.

• During 2 month, the lumen of the duodenum is

nd

obliterated by proliferation of cells in its walls.

However, the lumen is recanalized shortly thereafter.

• Since the foregut is supplied by the celiac artery &

the midgut is supplied by the superior mesenteric
artery, the duodenum is supplied by branches of
both arteries.
Liver & Gallbladder
• The liver primordium appears in the middle of 3rd week as an outgrowth of the
endodermal epithelium at the distal end of foregut.

• This outgrowth, the hepatic diverticulum, or liver bud, consists of rapidly proliferating
cells that penetrate the septum transversum.

• While hepatic cells continue to penetrate the septum, the connection between the
hepatic diverticulum & the foregut (duodenum) narrows, forming the bile duct.

• A small ventral outgrowth is formed by the bile duct & gives rise to gallbladder &
cystic duct.

• Epithelial liver cords intermingle with the vitelline & umbilical veins, which form
hepatic sinusoids.

• Liver cords differentiate into (liver cells) & form the lining of biliary ducts.
PANCREAS
• The pancreas is formed by two buds, dorsal & ventral, originating
from the endodermal lining of the duodenum.
• When the duodenum rotates to the right & becomes C-shaped, the
ventral pancreatic bud moves dorsally in a manner similar to the
shifting of the entrance of the bile duct .
• Finally, the ventral bud comes to lie immediately below & behind
the dorsal bud.
• Later, the parenchyma & the duct systems of the dorsal & ventral
pancreatic buds fuse.
 The ventral bud forms: the uncinate process & inferior part of head
of pancreas.
 The dorsal bud forms the remaining part of the gland.
PANCREAS
• The main pancreatic duct (of Wirsung) is formed by the distal part of the dorsal
pancreatic duct & the entire ventral pancreatic duct.
• The proximal part of the dorsal pancreatic duct either is obliterated or persists as a
small channel, the accessory pancreatic duct (of Santorini).
• The main pancreatic duct, together with the bile duct, enters the duodenum at the site
of the major papilla; the entrance of the accessory duct (when present) is at the site of
the minor papilla.
• In about 10% of cases, the duct system fails to fuse & the original double system
persists.
• Pancreatic islets (Langerhans) develop in 3 rd month.
• Insulin secretion begins at the 5th month, Glucagon & somatostatin-secreting cells
develop from parenchymal cells.
• Visceral mesoderm surrounding the pancreatic buds forms the pancreatic connective
tissue.
MIDGUT
•Suspended from the dorsal abdominal wall by a short mesentery & communicates
with the yolk sac by way of vitelline duct or yolk stalk.
• In the adult, the midgut begins immediately distal to the entrance of the bile
duct into the duodenum & terminates at the junction of the proximal 2/3 of the
transverse colon with the distal 1/3.
•Midgut is supplied by the superior mesenteric artery.
•Development of the midgut is characterized by rapid elongation of the gut & its
mesentery resulting in formation of primary intestinal loop.
•The cephalic limb of the loop develops into the distal part of duodenum, jejunum
& part of the ileum
•The caudal limb of the loop becomes the lower portion of the ileum, cecum,
appendix, ascending colon & proximal 2/3 of the transverse colon.
Physiological Herniation

•Development of the primary intestinal loop is characterized by rapid

elongation, particularly of the cephalic limb.
•As a result of the rapid growth & expansion of the liver, the abdominal
cavity temporarily becomes too small to contain all the intestinal loops &
they enter the extraembryonic cavity in the umbilical cord during the 6 th

week of development (physiological umbilical herniation).

Rotation of the Midgut

•The primary intestinal loop rotates around an axis formed by the

superior mesenteric artery.
•When viewed from the front, this rotation is counterclockwise &
approximately 270°.
•Even during rotation, elongation of the small intestinal loop continues &
jejunum & ileum form a number of coiled loops.
•The large intestine likewise lengthens considerably but does not
participate in the coiling phenomenon.

•Rotation occurs during herniation (90°), as well as during return of the

intestinal loops into the abdominal cavity (remaining 180°).
Retraction of Herniated Loops
•During the 10 week, herniated intestinal loops begin to return to the
th

abdominal cavity.
•Proximal portion of the jejunum, the first part to reenter the abdomen,
lie on left side.
•The cecal bud is the last part of the gut to reenter the abdominal
cavity.
•Temporarily, it lies in right upper quadrant & descends to right iliac
fossa, placing ascending colon & hepatic flexure on the right side.
•During this process, the distal end of cecal bud forms a narrow
diverticulum, the appendix. Since the appendix develops during descent
of the colon, its final position frequently is posterior to the cecum or
colon.These positions are called retrocecal or retrocolic,
HINDGUT
•The hindgut gives rise to the distal 1/3 of transverse colon, descending
colon, the sigmoid, the rectum, & the upper part of the anal canal.
•The endoderm of the hindgut also forms the internal lining of the
bladder & urethra.
•The terminal portion of the hindgut enters into the posterior region of
the cloaca, the primitive anorectal canal.
•Allantois enters into the anterior portion, primitive urogenital sinus.
•The cloaca itself is an endoderm-lined cavity covered at its ventral
boundary by surface ectoderm.
•This boundary between the endoderm & the ectoderm forms the
cloacal membrane.
HINDGUT
A layer of mesoderm, the urorectal septum, separates the region
•

between the allantois & hindgut.

•This septum is derived from the merging of mesoderm covering the yolk
sac & surrounding the allantois.

•At the end of 7thweek, the cloacal membrane ruptures, creating anal
opening for the hindgut & ventral opening for the urogenital sinus.

•Between the two, the tip of urorectal septum forms the perineal body.
HINDGUT
•The upper part (2/3) of the anal canal is derived from endoderm of the
hindgut &is supplied by the superior rectal artery, a continuation of the
inferior mesenteric artery, the artery of the hindgut.
•The lower part (1/3) is derived from ectoderm around the proctodeum.
, it is supplied by the inferior rectal arteries, branches of the internal
pudendal arteries.
•The junction between the endodermal & ectodermal regions of the
anal canal is delineated by the pectinate line, just below the anal
columns.
•At this line, the epithelium changes from columnar to stratified
squamous epithelium.