<- Home <- Arhive <- Vol. 24, Issue 1, March 2016

Rom J Leg Med24(1)71-77(2016)
© Romanian Society of Legal Medicine

Morphologic synergisms in the ortotaxy and heterotaxy of the subdiaphragmatic digestive system viscera. Consequences in pathology and forensic medicine

G. S. Dragoi, I. Marinescu, I. Dinca, E. Patrascu, P. R. Melinte

Abstract: Spatial location of the subdiaphragmatic digestive system viscera fascinates through the manner in which the 9-10 meters of tubular structures (gastroduodenal= approximate 50 cm; jejunal-ileal= approximate 7-8 meters; colorectal= approximate 1.5 meters) wreathe together within the relatively narrow space of abdominal cavity. Authors proposed themselves to perform an anatomic study regarding determinant factors of the combinatorial occupancy of abdominal-pelvic space by these viscera, during the dynamic of their epigenesis. The study was conducted on human biologic material: 8 embryos aged between 6-8 weeks and 15 fetuses, aged between 12-28 weeks. Analysis of relations between digestive system primordia and mesenteric mesenchyme derivates was achieved through macro- and microanatomic methods. Authors consider that the assessment of ortotaxy and heterotaxy of subdiaphragmatic digestive system viscera, as effects of intestinal rotation and malrotation created multiples confusions. The results of our observations, correlated with anatomic literature data, demonstrate that the location of viscera from peritoneal cavity is determined by morphologic synergisms synchronization between ectoblastic and mesenteric mesenchyme derivates. Intestinal rotations described by Fredet (1898), for the achievement of subdiaphragmatic digestive system viscera ortotaxy and heterotaxy appear as effects of tubular digestive structures growth and elongation and not as causes of these phenomenon. The asynchrony of morphologic synergisms generates heterotaxy, atresia, stenosis and abnormal peritoneal recesses which may become sites for congenital internal hernias, highly important in surgical pathology and forensic examination of peritoneal cavity.
Keywords: visceral ortotaxy, digestive system primordia, congenital internal hernia, intestinal rotation.

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