ANOMALIES OF THE MIDGUT

Most of them are anomalies of gut

rotation malrotation of the gut
that result from incomplete rotation
and / or fixation of the intestines
Omphalocele
Gastroschicis
Umbilical Hernia
Volvulus
Ileal Diverticulum
 OMPHALOCELE
Results from failure of the
intestines to return to the
abdominal cavity during
the 10th week
The covering of hernial sac
is the epithelium of
umbilical cord, a derivative
of the amnion
Occurs 1 : 5K 10K live
births RUPTURE OMPHALOCELE
 GASTROSCHISIS
Results from a defect near the median plane of the
ventral abdominal wall. The linear defects permits
extrusion of the abdominal viscera without involving the
umbilical cord

The defects usually occurs on the right side near the

median plane and is more common in males than females

The anomaly results from incomplete closure of the

lateral folds during the 4th week

Exposure to environmental drugs and chemical might be

involved in the etiology of gastroschisis
GASTROSCHISIS
 UMBILICAL HERNIA
When intestines return to the
abdominal cavity during the 10th
week then herniate through an
imperfectly closed umbilicus, an
umbilical hernia forms
Protruding mass (usually the greater
omentum , some of the small
intestine) is covered by
subcutaneous tissue and skin
 VOLVULUS
Small intestine fails to enter the abdominal
cavity normally and the messenteries fail to
undergo normal fixation; as the result
twisting of the intestines occurs
The duodenum and proximal colon are
attached to the posterior abdominal wall
The small intestine hangs by a narrow stalk
that contains the Sup Mesenteric artery and
vein; are ussually twisted in this stalk and
become obstructed at or near the duodenal
junction, circulation to the twist segment is
often restricted; and if the vessels are
completely obstructed , ganggrene will
Operative Procedure for
Incomplete Rotation of Cecum &
Midgut Volvulus

A. Unwinding of intestine
to correct volvulus

B. Transection of
peritoneal bands
extending from cecum in
right upper quadrant

C. Cecum relocated in left

lower quadrant