Die Entwicklung der Form des Magen-Darm-Kanales beim Menschen

Pernkopf, Eduard

doi:10.1007/bf02117699

Cited by 27 publications

(11 citation statements)

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“…Thus far, this has been generally accepted (Mall, 1899;Frazer & Robbins, 1915;Cyr et al 1986;Bowerman, 1993;Kim et al 2003). Previous studies described that in cases with intestines in the return phase, the CRLs were approximately 40 mm (range: 32-44 mm) (Mall, 1899;Pernkopf, 1925;Snyder & Chaffin, 1952;Kim et al 2003;Soffers et al 2015) (Table 1). In our study, the extraembryonic coelomic intestinal length and the ratio of the extraembryonic coelomic intestinal length to the entire intestinal length reached their maximum values in samples with CRLs of 32 mm.…”

Section: Discussionmentioning

confidence: 67%

“…). Previous studies described that in cases with intestines in the return phase, the CRLs were approximately 40 mm (range: 32–44 mm) (Mall, ; Pernkopf, ; Snyder & Chaffin, ; Kim et al. ; Soffers et al.…”

Section: Discussionmentioning

confidence: 97%

“…Some studies reported that the cecum (appendix) is the last intestinal segment to return (Mall, ; Frazer & Robbins, ), whereas others reported that the end of the small intestine (ileum) and cecum were the last segments to return (Pernkopf, ; Snyder & Chaffin, ; Soffers et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we observed that the height of the umbilical ring made stepwise increases from the transition to the return phase. We consider that the intra-abdominal space was generated so that it could accommodate the herniated portion of the intestine, similar Some studies reported that the cecum (appendix) is the last intestinal segment to return (Mall, 1899;Frazer & Robbins, 1915), whereas others reported that the end of the small intestine (ileum) and cecum were the last segments to return (Pernkopf, 1925;Snyder & Chaffin, 1952;Soffers et al 2015). Kluth et al (1995Kluth et al ( , 2003 observed a similar phenomenon in rat samples, specifically, the distal end of the intestine returned last, but not the cecum.…”

Section: Discussionmentioning

confidence: 99%

“…Mall (1899) 32 Loop 6 (distal end of the ileum) and the cecum are still within the cord Pernkopf (1925) 35…”

Section: Authors (Year) Crl (Mm) Observationsmentioning

confidence: 99%

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Return of the intestinal loop to the abdominal coelom after physiological umbilical herniation in the early fetal period

Nagata

Hatta

et al. 2019

Journal of Anatomy

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The intestine elongates during the early fetal period, herniates into the extraembryonic coelom, and subsequently returns to the abdominal coelom. The manner of herniation is well‐known; however, the process by which the intestinal loop returns to the abdomen is not clear. Thus, the present study was designed to document and measure intestinal movements in the early fetal period in three dimensions to elucidate the intestinal loop return process. Magnetic resonance images from human fetuses whose intestinal loops herniated (herniated phase; n = 5) while returning to the abdominal coelom [transition phase; n = 3, crown–rump length (CRL)] 37, 41, and 43 mm] and those whose intestinal loops returned to the abdominal coelom normally (return phase; n = 12) were selected from the Kyoto Collection. Intestinal return began from proximal to distal in samples with CRL of 37 mm. Only the ileum ends were observed in the extraembryonic coelom in samples with CRLs of 41 and 43 mm, whereas the ceca were already located in the abdominal coeloms. The entire intestinal tract had returned to the abdominal coelom in samples with CRL > 43 mm. The intestinal length increased almost linearly with fetal growth irrespective of the phase (R2 = 0.90). The ratio of the intestinal length in the extraembryonic coelom to the entire intestinal length was maximal in samples with CRLs of 32 mm (77%). This ratio rapidly decreased in three of the samples that were in the transition phase. The abdominal volumes increased exponentially (to the third power) during development. The intestinal volumes accounted for 33–41% of the abdominal volumes among samples in the herniated phase. The proportion of the intestine in the abdominal cavity increased, whereas that in the liver decreased, both without any break or plateau. The amount of space available for the intestine by the end of the transition phase was approximately 200 mm3. The amount of space available for the intestine in the abdominal coelom appeared to be sufficient at the beginning of the return phase in samples with CRLs of approximately 43 mm compared with the maximum intestinal volume available for the extraembryonic coelom in the herniated phase, which was 25.8 mm3 in samples with CRLs of 32 mm. A rapid increase in the space available for the intestine in the abdominal coelom that exceeded the intestinal volume in the extraembryonic coelom generated an inward force, leading to a ‘sucked back’ mechanism acting as the driving force. The height of the hernia tip increased to 8.9 mm at a maximum fetal CRL of 37 mm. The height of the umbilical ring increased in a stepwise manner between the transition and return phases and its height in the return phase was comparable to or higher than that of the hernia tip during the herniation phase. We surmised that the space was generated in the aforementioned manner to accommodate the herniated portion of the intestine, much like the intestine wrapping into the abdominal coelom as the height of the umbilical ring increased.

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