Abnormalities of GI development

Abnormalities of GI development

1. Duodenal atresia

   • related to Down syndrome
   • Failure of recanalization
   • Bilious vomiting; x ray "double bubble"
     • duodenal dilation

2. Congenital pyloric stenosis

   • common; male
   • pyloric wall hypertrophy
   • Palpable mass; projectile non-bilious vomitting

3. Umbilical Hernia

   • Intestines returns at week 10, but then herniate through imperfectly closed umbilius
     • re-herniation due to mechanical force
   • Midline protrusion containing small quantity of abdominal contents
     • Covered by SKIN

4. Omphalocele

   • persistence of herniated intestines
     • failed to return to abdomen in week 10
   • Midline protrusion containing variable amount intestines
     • covered by Peritoneum like transparent sac

5. Gastroschisis

   • Abdominal wall fails to close after intestines return to abdomen
     • re-herniation problem
   • Protrusion near (but NOT) midline containing some GI tract
     • NOT covered in skin or peritoneum

6. Meckel's diverticulum

   • Most common congenital anomaly of GI tract
     • Bleed, intussusception, volvulus, obstruction
   • Remnant of vitelline duct (yolk stalk)
     • Rule of 2: 2% population, 2 ft from ileocecal junction, 2 inches long; first 2 years
     • gastric epithelium and/or pancreatic tissue lines the interior

7. Hirschsprung's disease

   • Absence of innervation
     • No meissners & No Auerbach's ganglia (ANS)
   • Neural crest cells DON'T migrate into distal colon/rectum
   • Aganglionic area -> constricted
   • Proximal area -> dilated (Congenital Megacolon)
   • failure to pass meconium, constipation

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