UNIVERSITY OF Benghazi

Faculty of Medicine
Department of Human Anatomy and Embryology

Dr. Mustafa Karwad

Ass. Professor of Anatomy and Embryology
Lecture No. 5
 Special Embryology
Embryology of the Gut
Development of the foregut

Dr. Mustafa Karwad

Identify the results of folding.
Describe the development of the stomach, its origin, and
rotation.
Describe the development of liver, extra biliary tract and
the pancreas.
Identify the derivatives of the foregut.
Describe the development of spleen.
Identify the commonest anomalies related to the foregut.
introduction
Revision: the three germ layers.
Cells in each germ layer differentiate
into tissues and embryonic organs.
 Development of the digestive system
❑Early development of the gut tube:
o As the result of folding of the embryo, a part of the endoderm lined yolk
sac cavity is enclosed inside the embryo forming the lining of the gut tube
parts of the yolk sac remain outside the embryo.

Dr. Mustafa
 Development of the digestive system
❑The gut has four sections:
a. The pharyngeal gut or
pharynx: from the bucco-
pharyngeal membrane to the
respiratory (tracheobronchial)
diverticulum
b. The foregut: lies caudal to the
pharyngeal tube and extends as
far as the liver outgrowth.
c. The midgut.
d. The hindgut.
Dr. Mustafa
 Early development of the digestive tract
o Basic subdivisions of the gut tube:
• Cranio-caudal and lateral
folding cause the opening of
the gut tube to the yolk sac
forming a pocket toward the
head end of the embryo called
the "anterior (or cranial)
intestinal portal" and a
"posterior (or caudal) intestinal
portal" toward the tail of the
embryo. Dr. Mustafa
Folding of the digestive tract

Dr. Mustafa
Dr. Mustafa
 Embryonic folding
During folding:
✓ Somatic mesoderm is applied to the body wall to give rise to the parietal
peritoneum.
✓ Visceral (or splanchnic) mesoderm is wraps around the gut tube to form
the mesenteries that suspend the gut tube within the body cavity.
✓ The mesoderm immediately associated with the endodermal tube also
contributes to most of the wall of the gut tube.

Dr. Mustafa
 Embryonic folding
❑ Summary of germ layers contributions:
✓ Endoderm: mucosal epithelium, mucosal glands, and submucosal glands of
the GI tract.
✓ Mesoderm: lamina propria, muscularis mucosae, submucosal connective
tissue and blood vessels, muscularis externa, and adventitia/serosa
✓ Neural crest: neurons and nerves of the submucosal and myenteric plexus

Dr. Mustafa
 Early development of the digestive tract
o Notice that:
o As a result of embryonic
folding, the endoderm is
enclosed inside the embryo
to form the lining of the
gut tube.
o The cranial part of the
foregut is called (primitive
pharynx), from which the
respiratory system develops.
{It gives also other
derivatives in the head and
neck}. Dr. Mustafa
 Early development of the digestive tract
Foregut
o In the head fold of the
embryo:
✓Its cranial end is
closed by bucco-
pharyngeal membrane.

Vitello-intestinal duct

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 Early development of the digestive tract
Midgut
o It lies between the
foregut and hindgut.
o It is connected to:
✓ Foregut: by the anterior
intestinal portal.
✓ Hindgut: by the
posterior intestinal Vitello-intestinal
portal. duct

✓ Definitive yolk sac: by

vitello-intestinal duct,

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 Early development of the digestive tract
Hindgut

o It lies in the tail fold

of the embryo.
o Its caudal end is
closed by the cloacal
membrane.
Vitello-intestinal
duct

Dr. Mustafa
 Development of the Foregut
o As a result of elongation of the gut tube, the following structures appear
in cranio-caudal direction:
✓ Fusiform stomach.
✓ Duodenal lobe.
✓ Midgut loop.
✓ Cloaca.

Dr. Mustafa
 Early development of the digestive tract
✓ The midgut loop: which is connected to the vitello-intestinal duct.

➢ The cloaca: which is

the dilated caudal
part of the hindgut.
✓ It is connected to
allantois (tubular
process passing into
the umbilical cord).

Dr. Mustafa
o The abdominal part of the gut is connected to posterior abdominal wall by
dorsal mesentery: which is double layered mesentery & its name is
according to the GIT part attached to it: mesogastrium, mesoduodenum,
mesentery, mesocolon.

Dr. Mustafa
The derivatives of the gut regions are as follows:
FOREGUT MIDGUT HINDGUT
✓ Trachea & respiratory • Distal 1/3 of
o Lower duodenum
tract transverse colon
✓ Lungs o Jejunum • Descending colon
✓ Esophagus o Ileum • Sigmoid colon
✓ Stomach o Cecum • Rectum
✓ Liver o Appendix • Upper anal canal
✓ Gallbladder & bile
o Ascending colon • Urogenital sinus
ducts
✓ Pancreas (dorsal & o Proximal 2/3 of
ventral) transverse colon
✓ Upper duodenum
 The blood vessels of the gut
o Blood vessels derived from
dorsal aorta pass between
the two layers of
mesentery to supply the
gut:
o The celiac trunk: supplies
the foregut.
o The superior mesenteric
artery: supplies the midgut.
o The inferior mesenteric
artery: supplies the
hindgut.
Dr. Mustafa
The blood vessels of the gut

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 Development of the stomach Early appearance:
o At the age of 4 weeks, the stomach appears as a fusiform-dilatation in the
cranial most part of the abdominal foregut.
o It has:
✓ 2 ends: cranial (cardiac) and
caudal (pyloric) which lie in the
midline.
✓ 2 borders: ventral and dorsal (equal
in length).
✓ 2 surfaces: Rt. and Lt. which are
related to the Rt. and Lt. vagi.
✓ 2 peritoneal folds: ventral & dorsal
mesogastrium.
 Late changes:

o Growth: of dorsal border more

than anterior border. It forms
the greater curve.

o Development of liver within

the ventral mesogastrium (so
the formation of falciform
ligament and lesser omentum).
 Rotation of the stomach
o Rotation 90 degree to the right around
vertical axis. So the:
✓ Right and left surfaces become posterior
and anterior surfaces respectively.
✓ Right and left vagus nerves become
posterior and anterior gastric nerves
respectively.
✓ Lesser curve is right and greater curve
is left.
✓ Dorsal mesogastrium elongates on left
side and lesser sac is formed.
✓ Development of spleen (mesodermal)
within dorsal mesogastrium (so the
formation of gastrophrenic, gastrosplenic,
lienorenal and greater omentum folds).
Rotation of stomach
 After a clock-wise rotation of the stomach:
o The lesser sac lies behind lesser omentum, stomach, and anterior 2 layers
of greater omentum.
o Development of liver pushes the cardiac end to the left.
o The pyloric end will be to the right.
o The stomach descends to lower position in the abdomen due to the
elongation of esophagus.
 Congenital anomalies of the stomach
❑Pyloric stenosis: ❑Hour-glass stomach: ❑Thoracic stomach:
o Due to hypertrophy of o Due to constriction o Due to short
circular muscle of of the middle part esophagus, leading to
pyloric sphincter. of the stomach. presence of part of
stomach or whole
o It leads to obstruction
stomach in thoracic
and vomiting.
cavity (hiatus hernia).
 Congenital anomalies of the stomach Cont.
❑Reversed rotation:
o May occur as a part of reversed rotation of the whole organs (situs
inversus totalis).
 Development of the duodenum
❑ During the 4th week of gestation,
the duodenum begins to develop
from a duodenal loop (convex
forwards) which is derived from
two sources:
o The caudal end of the foregut.
o The cranial end of the midgut.
▪ Notice the formation of the liver
bud (just proximal to the junction
of both parts) from the convexity
of the duodenal loop.
 Development of the duodenum Cont.

o The whole loop is connected to posterior abdominal wall by meso-

duodenum, while the 1st inch only is connected to the anterior abdominal
wall by ventral mesogastrium.
 Development of the duodenum Cont.

o Rotation of the loop occurs

with the stomach (90 degrees
to the right), and fusion with
the peritoneum of posterior
abdominal wall occurs.
o Notice the position of opening
of the liver bud (future
common bile duct) after
rotation.
 Development of the duodenum Cont.
o Proliferation of epithelial lining of the duodenum leads to obliteration
of the lumen (at 6th week).
o Recanalization occurs at 3rd month.

o The duodenum gets its arterial supply from both celiac and superior
mesenteric arteries (Derivative of foregut & midgut).
Congenital anomalies:
✓ Duodenal atresia: due to failure of
recanalization of the lumen.
✓ Duodenal stenosis: due to
incomplete recanalization of the
lumen.
Re-canalization of duodenum
 Development of the liver & extra hepatic biliary system
o During the 3rd week the hepatic diverticulum (liver bud) extends off
foregut & grows into mesoderm of ventral mesentery.
o The liver is developed from 3 sources:
- Liver bud (endoderm), Vitelline veins (mesoderm), Septum transversum
(mesoderm).
 Development of the liver
1. Liver bud: a diverticulum from the convexity of the duodenum divides
into:
i. Pars cystica gall bladder & cystic duct.
ii. Pars hepatica right & left hepatic duct, bile canaliculi & cords of
liver cells.
2. Vitelline veins: break into the blood sinusoids between the cords of
liver cells.
3. Septum transversum: gives the fibrous capsule and stroma of the liver.
o Common bile duct:
✓ Which connects liver and
foregut, is remnant of hepatic
diverticulum.
 Development of Gallbladder
✓ Develops as a secondary out-pouching from the hepatic diverticulum that
grows into ventral mesentery.
✓ Its connection to hepatic diverticulum will become cystic duct.
 Commonest congenital Abnormalities
✓ Abnormalities of budding of developing gallbladder from hepatic duct can
create variety of gallbladder anomalies.
✓ Typically asymptomatic, creating difficulty during surgical procedures on
gallbladder or during imaging.

Agenesis of the gallbladder Absence of cystic duct

❖ Biliary Tree Abnormalities:
✓ Absence of a portion of bile ducts,
biliary atresia, can create very
severe problems.
✓ Obstruction or closure of bile
ducts outside of liver resulting in
bile being unable to leave the
liver.
✓ Causes jaundice, cirrhosis and
eventually death.
✓ Less severe variations of biliary tree include accessory bile ducts
emptying into gallbladder directly from liver as well as cysts of duct.
 Development of the Pancreas
❖ Develop from 2 buds
1. Ventral pancreas:
✓ From the proximal part of the liver bud.
✓ It rotates on the right side of the duodenal loop to fuse with the dorsal
pancreas within the mesoduodenum.
 Development of the
Pancreas
❖Dorsal pancreas:
✓ From the concavity of the
duodenal loop (cranial to
the level of the liver
bud).
✓ It gives part of the head,
in addition to the rest of
the pancreas (neck, body
and tail).
✓ The ventral bud along
with common bile duct
rotate clockwise around
the duodenum.
 Development of the Pancreas
❖The ventral & dorsal buds, fuse along with their ducts, to from the adult
pancreas & main pancreatic duct which drains the pancreas through the
major duodenal papilla, along with the common bile duct.
 Development of pancreas
❖After rotation of the duodenum and absorption of the mesoduodenum, the
pancreas becomes retroperitoneal.
✓ Pancreatic acini: develop as buds from the pancreatic ducts.
✓ Islets of Langerhans: develop also as buds from the ducts (3rd month) but
later separate from the ducts. Insulin secretion starts at (5th month).
Pancreas Embryology
 Development of the Pancreatic duct
❖ At an early stage: it is drained by 2 ducts:
✓ The duct of dorsal pancreas (cranial).
✓ The duct of ventral pancreas (caudal).
 Development of the Pancreatic duct
❖ At an late stage: It is drained by 2 ducts:
✓ Main pancreatic duct: the distal part of the dorsal duct & the proximal
part of the ventral duct. Remember that both common bile duct and main
pancreatic duct open into ampulla of vater.
✓ Accessory pancreatic duct: the remaining proximal part of the dorsal duct,
it opens cranial to the main duct.
Accessory pancreas: Pancreatic tissue invades
submucosa of the stomach.

Annular pancreas: Pancreatic tissue encircling

the duodenum (ring) & may constrict it.

Absent ventral pancreatic duct: the dorsal

duct opens separately above the bile duct.
 Development of the spleen
o The spleen arises during the 6th week from mesodermal cells located in
the dorsal mesogastrium.
o The cells form the parenchyma, stroma and capsule of the spleen, which
then become infiltrated with hematopoietic cells.
o The spleen is supplied by a large splenic artery.
Posterior
liver Abd. wall
Dorsal
mesoderm

Stomach

Ventral mesoderm
 Development of the spleen
o The part of the dorsal mesogastrium which lies between the greater
curvature of the stomach & spleen is Gastro-splenic ligament.
o The part of the dorsal mesogastrium which lies between the spleen & left
kidney is Lienorenal ligament.

Stomach
Gastro-splenic lig.

Kidney

Spleen
Linorenal lig.
Dr. Mustafa Karwad