Midgut Carcinoid
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The midgut is the portion of the
embryo An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male spe ...
from which most of the intestines develop. After it bends around the superior mesenteric artery, it is called the "midgut loop". It comprises the portion of the alimentary canal from the end of the
foregut The foregut is the anterior part of the alimentary canal, from the mouth to the duodenum at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. The foregut arises from the endoderm, deve ...
at the opening of the
bile duct A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. Bile is required for the digestion of food and is secreted by the liver into passages that carry bile toward the hepatic duct. It ...
to the
hindgut The hindgut (or epigaster) is the posterior ( caudal) part of the alimentary canal. In mammals, it includes the distal one third of the transverse colon and the splenic flexure, the descending colon, sigmoid colon and up to the ano-rectal juncti ...
, about two-thirds of the way through the transverse colon.


In the embryo

During development, the human midgut undergoes a rapid phase of growth in which the loop of midgut
hernia A hernia is the abnormal exit of tissue or an organ (anatomy), organ, such as the bowel, through the wall of the cavity in which it normally resides. Various types of hernias can occur, most commonly involving the abdomen, and specifically the gr ...
tes outside of the abdominal cavity of the
fetus A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal deve ...
and protrudes into the umbilical cord. This herniation is physiological (occurs normally). Later in development, the fetus's body catches up in size relative to the midgut and creates adequate room in the abdominal cavity for the entirety of the midgut to reside. The midgut loops slip back out of the umbilical cord and the physiological hernia ceases to exist. This change coincides with the termination of the
yolk sac The yolk sac is a membranous sac attached to an embryo, formed by cells of the hypoblast layer of the bilaminar embryonic disc. This is alternatively called the umbilical vesicle by the Terminologia Embryologica (TE), though ''yolk sac'' is far ...
and the counterclockwise rotation of the two limbs of the midgut loop around their combined central axis.Drake, Richard L., et al. ''Gray's anatomy for students''. Philadelphia, PA: Churchill Livingstone/Elsevier, 2010, p. 259


In the adult


Organs in the adult midgut

*
Duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
(
distal Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
half of 2nd part, 3rd and 4th parts) * Jejunum * Ileum * Cecum *
Appendix Appendix, or its plural form appendices, may refer to: __NOTOC__ In documents * Addendum, an addition made to a document by its author after its initial printing or publication * Bibliography, a systematic list of books and other works * Index (pub ...
*
Ascending colon ''Ascending'' is a science fiction novel by the Canadian writer James Alan Gardner, published in 2001 by HarperCollins Publishers under its various imprints.HarperCollins, Avon, HarperCollins Canada, SFBC/Avon; paperback edition 2001, Eos Books. ...
*
Hepatic flexure In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. Note ...
of colon *
Transverse colon In human anatomy, the transverse colon is the longest and most movable part of the colon. Anatomical position It crosses the abdomen from the ascending colon at the right colic flexure (hepatic flexure) with a downward convexity to the descend ...
(
proximal Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
two-thirds)


Vascular, lymphatics and innervation

Arterial supply to the midgut is from the superior mesenteric artery, an unpaired branch of the aorta. Venous drainage is to the
portal venous system In the circulatory system of animals, a portal venous system occurs when a capillary bed pools into another capillary bed through veins, without first going through the heart. Both capillary beds and the blood vessels that connect them are co ...
.
Lymph Lymph (from Latin, , meaning "water") is the fluid that flows through the lymphatic system, a system composed of lymph vessels (channels) and intervening lymph nodes whose function, like the venous system, is to return fluid from the tissues to ...
from the midgut drains to prevertebral superior mesenteric nodes located at the origin of the superior mesenteric artery from the aorta. Portal drainage carries all non-lipid nutrients from digestion to the
liver The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...
for processing and detoxification, while lymphatic drainage carries fatty
chyle Chyle (from the Ancient Greek, Greek word χυλός ''chylos'', "juice") is a milky bodily fluid consisting of lymph and emulsified fats, or free fatty acids (FFAs). It is formed in the small intestine during digestion of fatty foods, and taken ...
to the cisterna chyli. Parasympathetic
innervation A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
of the midgut is from the superior mesenteric plexus, while sympathetic innervation is from the lesser splanchnic nerve.


Clinical significance

* Malrotation of the midgut during development can lead to volvulus. * Pain in the midgut is referred to the region around the belly button As stated, in development a loop of midgut herniates outside of the abdominal cavity into the umbilical cord. If this persists after birth it is called an
omphalocele Omphalocele or omphalocoele also called exomphalos, is a rare abdominal wall defect. Beginning at the 6th week of development, rapid elongation of the gut and increased liver size reduces intra abdominal space, which pushes intestinal loops out of ...
. In omphalocele, there is a defect in the development of the
anterior abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the vi ...
.


See also

*
Foregut The foregut is the anterior part of the alimentary canal, from the mouth to the duodenum at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. The foregut arises from the endoderm, deve ...
*
Hindgut The hindgut (or epigaster) is the posterior ( caudal) part of the alimentary canal. In mammals, it includes the distal one third of the transverse colon and the splenic flexure, the descending colon, sigmoid colon and up to the ano-rectal juncti ...


References


External links

* * – "Midgut Volvulus" *
Umich.edu – development
{{Authority control Embryology of digestive system