Factors involved in the ‘rotation’ of the human embryonic stomach around its longitudinal axis: computer‐assisted morphometric analysis

Abstract

The majority of studies as to whether gastric and nongastric factors are involved in the ' rotation ' of the human embryonic stomach around its longitudinal axis have been morphological. The aim of this study was to analyse, with morphometric support, the influence on the angular modifications during gastric rotation of the simultaneous changes of the gastric walls and mesenteric growth, and the volumes of organs adjacent to the stomach (right, left and posterior groups). Computer imaging techniques were applied on cross sections of a graded series of 10 human embryos (from Carnegie stage (CS) 11) and 2 fetuses. A clockwise gastric rotation occurred during the embryonic period. The most rapid angular modifications took place from CS 11 to 16, after the rotation became oscillatory with angular changes in clockwise and anticlockwise directions, reaching the highest value at CS 18 (at the supraomental part of the stomach : 54.37m ; at the omental part : 68.03m) ; after this period the angular values tended to stabilise. The predominant growth of the left gastric wall over the right and the changes in the width of the gastric mesentery were the most persistent factors involved in the modifications of the transverse gastric angle during the embryonic period although without relationship to their direction. During the increasing angular phases, clockwise rotation was promoted by the decrease of the volume of any group of organs adjacent to the stomach. When the volume of the left and posterior groups increased simultaneously, clockwise or anticlockwise angular directional change was related to the respective decrease or increase adjacent organ volume to the right. We conclude that the stomach of the human embryo undergoes heterogeneous and multifactorial rotation as a consequence of the overall increase in gastric wall growth to the left and the increase of gastric mobility produced by the previous mesenteric enlargement, and that the rotational direction results from the forces exerted on the stomach and the gastric mesenteries by the adjacent organs.

Morphogenesis and Three‐Dimensional Movement of the Stomach During the Human Embryonic Period

“…Previous studies on stomach movements were designed primarily to assess the rotation around the longitudinal axis because this movement reflects and explains the anatomy around the stomach in adults (postnatal period), such as the presence of the lesser and greater peritoneal sacs, and the relative position of the gastric nerves and the gastric mesenteric arteries. Discrepancies in the results may be due to movements other than the rotation around the longitudinal axis, which may interfere with the analysis (Nebot-Cegarra et al, 1999). Due to this, precise threedimensional (3D) analysis of stomach movements was required.…”

Dynamics of Stomach Growth in the Human Fetal Period: a Postmortem Study

“…For obstetricians, neonatologists and pathologists knowledge of fetal stomach development allows correct diagnoses and treating of its anomalies, pathologies and varieties. Mechanisms of gastrointestinal tract separate parts growth is less examined (Hussein et al, 1999;Nebot-Cegarra et al, 1999). Disputable attempt in the opinion of many authors is to estimate the moment of final stomach development, characteristic for fetal period.…”

Dextrocardia and Situs Inversus Totalis in a Nigerian Cadaver: A Case Report of Rare Anomaly

“…Nawaz et al in their report described a case of two newborns with situs inversus in association with congenital duodenal obstruction. Although the mechanism responsible for the malrotation of the intestinal loop in our case report is yet to be completely understood, evidence from the literatures had it that the direction of rotation is under the influence of the forces exerted by the adjacent organs on the intestine and its mesentery (Naboth-Cegara, 1999;Abdur-Rahman et al). The right lung that was observed to be uni-lobed and the larger of the two lungs make this case report a rare one (Fig.…”