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Erschienen in: Surgical and Radiologic Anatomy 5/2009

01.06.2009 | Original Article

The development of fetal pylorus during the fetal period

verfasst von: Esra Koyuncu, Mehmet Ali Malas, Soner Albay, Neslihan Cankara, Nermin Karahan

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 5/2009

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Abstract

Objective

The objective of this study was to explore the localization of the pylorus, its macroscopic and microscopic development and relationship with neighboring structures.

Materials and methods

The study is carried out on 160 human fetuses aged between 9 and 40 weeks of gestation. Abdomen was divided into four quadrants by horizontal and vertical planes passing through the umbilicus. Topographical localization of the pylorus in reference to these quadrants and its distance were determined. Pylorus was divided into pre-pyloric, pyloric, and post-pyloric regions. Starting from the pre-pyloric end, serial sections spanning whole pyloric part were obtained. Wall thickness, the thickness of the muscular coat were measured under light microscope using sections stained with hematoxylin eosin. Sections with the thickest muscular coat were considered as the region where pyloric sphincter was.

Findings

Pylorus was located in the right upper quadrant, on the median plane and in the left upper quadrant. There was a significant relation between the thickness of the muscular coat in the stomach, duodenum and the pyloric region and gestational age. In the region of the pyloric sphincter, the rate of increase in the thickness of the muscular coat was higher in the first and the first half of the second trimesters than term fetuses.

Conclusion

We believe that data obtained in the present study will contribute to the assessment of development of the pyloric region in intra-uterine cases.
Literatur
1.
Zurück zum Zitat Bannister LH (1995) Alimentary system. In: Gray’s anatomy, 38th edn. Churchill Livingstone Medical Division of Langman, London, pp 1795–1807 Bannister LH (1995) Alimentary system. In: Gray’s anatomy, 38th edn. Churchill Livingstone Medical Division of Langman, London, pp 1795–1807
2.
Zurück zum Zitat Blumhagen JD, Maclin L, Krauter D, Rosenbaum DM, Weinberger E (1998) Sonographic diagnosis of hypertrophic pyloric stenosis. AJR Am J Roentgenol 150(6):1367–1370 Blumhagen JD, Maclin L, Krauter D, Rosenbaum DM, Weinberger E (1998) Sonographic diagnosis of hypertrophic pyloric stenosis. AJR Am J Roentgenol 150(6):1367–1370
3.
Zurück zum Zitat Bourdelat D, Barbet JP, Chevrel JP (1992) Fetal development of the pyloric muscle. Surg Radiol Anat 14(3):223–226PubMedCrossRef Bourdelat D, Barbet JP, Chevrel JP (1992) Fetal development of the pyloric muscle. Surg Radiol Anat 14(3):223–226PubMedCrossRef
4.
Zurück zum Zitat Cetin E, Malas MA, Albay S, Cankara N (2006) The development of stomach during the fetal period. Surg Radiol Anat 28(5):438–446PubMedCrossRef Cetin E, Malas MA, Albay S, Cankara N (2006) The development of stomach during the fetal period. Surg Radiol Anat 28(5):438–446PubMedCrossRef
5.
Zurück zum Zitat Cook RCM (1990) Gastric outlet obstruction. In: Lister J, Irving Irene M, Rickham PP (eds) Neonatal surgery, 3th edn. Butterworth, London, pp 403–408 Cook RCM (1990) Gastric outlet obstruction. In: Lister J, Irving Irene M, Rickham PP (eds) Neonatal surgery, 3th edn. Butterworth, London, pp 403–408
6.
Zurück zum Zitat Goldstein I, Reece EA, Yarkoni S, Wan M, Green JL, Hobbins JC (1987) Growth of the fetal stomach in normal pregnancies. Obstet Gynecol 70(4):641–644PubMed Goldstein I, Reece EA, Yarkoni S, Wan M, Green JL, Hobbins JC (1987) Growth of the fetal stomach in normal pregnancies. Obstet Gynecol 70(4):641–644PubMed
7.
Zurück zum Zitat Guarino N, Shima H, Puri P (2000) Structural immaturity of the pylorus muscle in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 16(4):282–284PubMedCrossRef Guarino N, Shima H, Puri P (2000) Structural immaturity of the pylorus muscle in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 16(4):282–284PubMedCrossRef
8.
Zurück zum Zitat Henrich M (1986) Clinical anatomy of the pyloric region. Zentralbl Chir 111(9):518–525PubMed Henrich M (1986) Clinical anatomy of the pyloric region. Zentralbl Chir 111(9):518–525PubMed
9.
Zurück zum Zitat Howard CV, Reed MG (1998) Unbiased stereology, three-dimensional measurement in microscopy. BIOS Scientific Publishers, Oxford, pp 39–68 Howard CV, Reed MG (1998) Unbiased stereology, three-dimensional measurement in microscopy. BIOS Scientific Publishers, Oxford, pp 39–68
10.
Zurück zum Zitat Keet AD (1982) The anatomical extent of the pyloric sphincteric cylinder, the pyloric mucosal zone and the pyloric antrum. S Afr Med J 62(10):329–333PubMed Keet AD (1982) The anatomical extent of the pyloric sphincteric cylinder, the pyloric mucosal zone and the pyloric antrum. S Afr Med J 62(10):329–333PubMed
11.
Zurück zum Zitat Kepkep K, Tuncay YA, Göynümer G, Yetim G (2005) Nomogram of the fetal gastric size development in normal pregnancy. J Perinat Med 33(4):336–339PubMedCrossRef Kepkep K, Tuncay YA, Göynümer G, Yetim G (2005) Nomogram of the fetal gastric size development in normal pregnancy. J Perinat Med 33(4):336–339PubMedCrossRef
12.
Zurück zum Zitat Kobayashi H, O’Briain DS, Puri P (1994) Selective reduction in intramuscular nerve supporting cells in infantile hypertrophic pyloric stenosis. J Pediatr Surg 29(5):651–654PubMedCrossRef Kobayashi H, O’Briain DS, Puri P (1994) Selective reduction in intramuscular nerve supporting cells in infantile hypertrophic pyloric stenosis. J Pediatr Surg 29(5):651–654PubMedCrossRef
13.
Zurück zum Zitat Malas MA, Aslankoç R, Ungör B, Sulak O, Candir O (2003) The development of jejunum and ileum during the fetal period. Early Hum Dev 74(2):109–124PubMedCrossRef Malas MA, Aslankoç R, Ungör B, Sulak O, Candir O (2003) The development of jejunum and ileum during the fetal period. Early Hum Dev 74(2):109–124PubMedCrossRef
14.
Zurück zum Zitat Malas MA, Sulak O, Gökçimen A, Sari A (2004) Development of the vermiform appendix during the fetal period. Surg Radiol Anat 26(3):202–207PubMedCrossRef Malas MA, Sulak O, Gökçimen A, Sari A (2004) Development of the vermiform appendix during the fetal period. Surg Radiol Anat 26(3):202–207PubMedCrossRef
15.
Zurück zum Zitat Moore KL, Persaud TVN (1998) The developing human (clinically oriented embryology), 6th edn, pp 109–110 Moore KL, Persaud TVN (1998) The developing human (clinically oriented embryology), 6th edn, pp 109–110
16.
Zurück zum Zitat O’Keeffe FN, Stansberry SD, Swischuk LE, Hayden CK Jr (1991) Antropyloric muscle thickness at US in infants: what is normal? Radiology 178(3):827–830PubMed O’Keeffe FN, Stansberry SD, Swischuk LE, Hayden CK Jr (1991) Antropyloric muscle thickness at US in infants: what is normal? Radiology 178(3):827–830PubMed
17.
Zurück zum Zitat Oue T, Puri P (1999) Smooth muscle cell hypertrophy versus hyperplasia in infantile hypertrophic pyloric stenosis. Pediatr Res 45:853–857PubMedCrossRef Oue T, Puri P (1999) Smooth muscle cell hypertrophy versus hyperplasia in infantile hypertrophic pyloric stenosis. Pediatr Res 45:853–857PubMedCrossRef
18.
Zurück zum Zitat Pilu G, Kypros N (2002) 18–23 week pregnancy ultrasound, prenatal diagnosis of fetal anomalies (translation). Ermiş H (ed) June, pp 67–75 Pilu G, Kypros N (2002) 18–23 week pregnancy ultrasound, prenatal diagnosis of fetal anomalies (translation). Ermiş H (ed) June, pp 67–75
19.
Zurück zum Zitat Rohrschneider WK, Mittnacht H, Darge K, Tröger J (1998) Pyloric muscle in asymptomatic infants: sonographic evaluation and discrimination from idiopathic hypertrophic pyloric stenosis. Pediatr Radiol 28(6):429–434PubMedCrossRef Rohrschneider WK, Mittnacht H, Darge K, Tröger J (1998) Pyloric muscle in asymptomatic infants: sonographic evaluation and discrimination from idiopathic hypertrophic pyloric stenosis. Pediatr Radiol 28(6):429–434PubMedCrossRef
20.
Zurück zum Zitat Sase M, Asada H, Okuda M, Kato H (2002) Fetal gastric size in normal and abnormal pregnancies. Ultrasound Obstet Gynecol 19(5):467–470PubMedCrossRef Sase M, Asada H, Okuda M, Kato H (2002) Fetal gastric size in normal and abnormal pregnancies. Ultrasound Obstet Gynecol 19(5):467–470PubMedCrossRef
21.
Zurück zum Zitat Shima H, Ohshiro K, Puri P (2000) Increased local synthesis of epidermal growth factors in infantile hypertrophic pyloric stenosis. Pediatr Res 47(2):201–207PubMedCrossRef Shima H, Ohshiro K, Puri P (2000) Increased local synthesis of epidermal growth factors in infantile hypertrophic pyloric stenosis. Pediatr Res 47(2):201–207PubMedCrossRef
22.
Zurück zum Zitat Spinelli C, Bertocchini A, Massimetti M, Ughi C (2003) Muscle thickness in infants hypertrophic pyloric stenosis. Pediatr Med Chir 25(2):148–150PubMed Spinelli C, Bertocchini A, Massimetti M, Ughi C (2003) Muscle thickness in infants hypertrophic pyloric stenosis. Pediatr Med Chir 25(2):148–150PubMed
23.
Zurück zum Zitat Sadler TW (1995) Langman’s Medical embryology, 7th edn, Williams and Wilkins, Baltimore, pp 236–242 Sadler TW (1995) Langman’s Medical embryology, 7th edn, Williams and Wilkins, Baltimore, pp 236–242
24.
Zurück zum Zitat Vanderwinden JM, Liu H, De Laet MH, Vanderhaeghen JJ (1996) Study of the interstitial cells of cajal in infantile hypertrophic pyloric stenosis. Gastroenterology 111:279–288PubMedCrossRef Vanderwinden JM, Liu H, De Laet MH, Vanderhaeghen JJ (1996) Study of the interstitial cells of cajal in infantile hypertrophic pyloric stenosis. Gastroenterology 111:279–288PubMedCrossRef
Metadaten
Titel
The development of fetal pylorus during the fetal period
verfasst von
Esra Koyuncu
Mehmet Ali Malas
Soner Albay
Neslihan Cankara
Nermin Karahan
Publikationsdatum
01.06.2009
Verlag
Springer-Verlag
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 5/2009
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-008-0449-8

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