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Intestinal malrotation is a congenital anomaly of rotation of the midgut. It occurs during the first trimester as the fetal gut undergoes a complex series of growth and development. Malrotation can lead to a dangerous complication called volvulus, in which cases emergency surgery is indicated. [1]
The small intestine forms loops (B2) and slides back into the abdomen (B3) during resolution of the hernia. Meanwhile, the cecum moves from the left to the right side, which represents the additional 180° counterclockwise rotation of the intestine (C, central view). [3] In the process of lengthening growth, the intestinal duct herniates and ...
The greater omentum develops from the dorsal mesentery that connects the stomach to the posterior abdominal wall. During its development, the stomach undergoes its first 90° rotation along the axis of the embryo, so that posterior structures are moved to the left and structures anterior to the stomach are shifted to the right.
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 and the counterclockwise rotation of the two limbs of the midgut loop around their combined central axis. [1]
This rotation also affects the part of the gastrointestinal tube immediately below the stomach, which will go on to become the duodenum. By the end of the fourth week, the developing duodenum begins to spout a small outpouching on its right side, the hepatic diverticulum , which will go on to become the biliary tree .
Human embryology is the study of this development during the first eight weeks after fertilization. The normal period of gestation (pregnancy) is about nine months or 36 weeks. The germinal stage refers to the time from fertilization through the development of the early embryo until implantation is completed in the uterus .
Gastrulation is the stage in the early embryonic development of most animals, during which the blastula (a single-layered hollow sphere of cells), or in mammals the blastocyst, is reorganized into a two-layered or three-layered embryo known as the gastrula. [1]
The stomach can also be affected. [6] Diagnosis is typically with medical imaging such as plain X-rays, a GI series, or CT scan. [1] Initial treatment for sigmoid volvulus may occasionally occur via sigmoidoscopy or with a barium enema. [3] Due to the high risk of recurrence, a bowel resection within the next two days is generally recommended. [3]