Sviluppo apparato digerente e respiratorio

Sviluppo apparato digerente

foregut

inte

stin

o f

arin

geo

VII-VIII settimana

Intestino medio e stomaco

Sviluppo PANCREAS

cellule endoteliali

regione dorsale tubo intestinale regione

dorsale pancreas

aorte dorsali

SHH FGF2 Attivina

RA V

EGF

VEG

F

VEG

F

tratto intestino anteriore

aorte dorsali

notocorda

notocorda

vene vitelline

tratto intestino anteriore

aorta dorsale

vena vitellina

notocorda

abbozzo dorsale pancreas

abbozzo ventrale pancreas

mesenchima

FGF1

0

Pdx1 Pdx1 dotto biliare

vena vitellina

V settimana

VI-VII settimana

VII-VIII settimana

Tra l’VIII e la IX settimana l’abbozzo ventrale del pancreas ruota e si unisce a quello dorsale

ectoderma endoderma mesoderma

int.ant int.medio int.post.

polmoni fegato cistifellea pancreas

epatociti epitelio biliare mesenchima epatico

BMP

setto trasverso

mesoderma cardiogenico

FGF

highFGF

Formazione capsula e legamenti del fegato

• Oesophageal atresia e fistula tracheoesofagea • Oesophageal atresia has an estimated incidence of 1 in 3,000 births. • Onfalocele e gastroschisi occur in about 1 birth in 3,000. There is a deficiency of the

abdominal wall and contents can herniate into this space. • Prune belly syndrome is a rare condition in which about 97% are boys. There is deficiency of

the abdominal wall and cryptorchidism, hydronephrosis and possibly pulmonary hypoplasia but the gut is usually intact.

• Congenital diaphragmatic hernia • This condition results from failure of diaphragm to fuse during fetal development allowing

abdominal organs to migrate into the chest. • Hypertrophic pyloric stenosis • Hypertrophic pyloric stenosis is caused by diffuse hyperplasia of the smooth muscle of the

stomach antrum and pylorus. The incidence is 2 to 4 per 1,000. • Intestinal atresia, stenosis and webs • These can occur at any level but the most common place for atresia, after the oesophagus, is

the duodenum. The incidence of duodenal atresia is between 1 in 10,000 and 1 in 30,000 births.

• Volvulus is a complete twisting of a loop of intestine around its mesenteric attachment and can happen anywhere in the GI tract.

• Midgut volvulus refers to the twisting of entire midgut along the axis of superior mesenteric artery and is the most common type of volvulus.

• Meckel’s diverticulum is a vestigial remnant of the vitello-intestinal duct and is the most common malformation of the GI tract.

• Hirschsprung’s disease • Hirschsprung’s disease is caused by failure of development of the neural ganglia in the

myenteric and submucosal plexus of the rectum. • Imperforate anus • Failure to pass meconium in the first 24 hours of life should lead to examination of the rectum.

Milder lesions may cause constipation later on.

omphalocele hole in belly button intestines covered by protective sac

gastroschisis hole next to belly button intestines not covered by a protective sac

4-6 settimana