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Developmental Anatomy and Congenital Anomalies of Hepatobiliary System2

The document discusses the development of the hepatobiliary system from the foregut. It describes how the liver, gallbladder and bile ducts develop from glandular buds in the third week. It also discusses the normal anatomy and functions of these structures as well as some common congenital abnormalities.

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debdeepbhattacharya411
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72 views25 pages

Developmental Anatomy and Congenital Anomalies of Hepatobiliary System2

The document discusses the development of the hepatobiliary system from the foregut. It describes how the liver, gallbladder and bile ducts develop from glandular buds in the third week. It also discusses the normal anatomy and functions of these structures as well as some common congenital abnormalities.

Uploaded by

debdeepbhattacharya411
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Developmental Anatomy and

Congenital Anomalies of
Hepatobiliary System
Asst.Prof Dr.Sanjay Yadav
Three glandular buds arise from the distal end of the
foregut during the 3rd weeks

Day 22-The hepatic bud projects


into the ventral mesogastrium and
grows in the septum transversum

Day 28–The ventral pancreatic bud


grows into the ventral mesogastrium

Day 26–The dorsal pancreatic bud grows into the dorsal mesogastrium
The liver and biliarysystem develop from the hepatic
diverticulum

•The distal end proliferates rapidly in the


septum transversum to form the hepatocytes
and intra-hepatic biliary system

•The proximal part in the ventral


mesogastrium proliferate slowly, becomes
relatively narrow and forms the
extrahepatic biliary system

•A secondary outgrowth from it forms the gall


bladderand cystic duct during the 4thweek
(day 24)
Rudiments of the Liver and Biliary system
• Hepatic diverticulum Liver cords and
Biliary duct epithelium

• Vitelline and umbilical veins Sinusoids and


portal vein
• Septum transversum mesoderm Space of Disse
Kupffer cells
Haemopoietic tissue
Hepatic artery
Connective tissue
Development of liver function
• Bile production starts at 12th wks
• Gives dark green color to the meconium
• Hematopoiesis begins during 4th wks
Normal anatomy
• Pear – shaped sac
• Lies in the fossa on the inferior surface of liver
• Normal capacity about 25 to 30 ml
• Anatomic areas –fundus, body, and neck
Normal anatomy
Normal anatomy
• Blood supply : Cystic artery
• Venous drainage : Small veins enter directly to the liver
• Lymphatic drainage : Nodes at the neck
Normal anatomy
• Cystic duct : lengths 3cm but variable, diameter 1-3mm
• Common hepatic duct : 2.5 cm long, formed by left and
right hepatic duct
• Common bile duct : 7.5 cm long, formed by the junction
of the cystic duct and CHD
 Supraduodenal portion
 Retroduodenal portion
 Infraduodenal portion
 Intraduodenal portion
Congenital abnormalities of the gall
bladder and bile duct
Gall bladder anomalies :
A.Formation :
 Phrygian cap – present in 2 to 6%
 Bilobed gall bladder
 Diverticulum of the gall bladder – 0.08%
 Septum of gall bladder
Congenital abnormalities of the gall
bladder and bile duct
Gall bladder anomalies :
B. Number:
 Agenesis – more than 200 cases reported
 Double gall bladder
Congenital abnormalities of the gall
bladder and bile duct
Gall bladder anomalies :
C. Position:
 Floating GB
 Intra hepatic GB
 Left sided GB
Congenital abnormalities cystic duct
Vascular anomalies
Vascular anomalies
Vascular anomalies
Vascular anomalies
• Most dangerous anomalies are where the
hepatic artery takes a tortuous course on in
front of the origin of the cystic duct or right
hepatic artery is tortuous and short cystic
artery
Extrahepatic Biliary Atresia
• Incidence – 1 per 1200 live birth
• Male and female affects equally
• Etiology is unclear
• Intrahepatic changes also occur leads to cirrhosis and
portal hypertension
• Untreated death occurs before age of 3yrs
Extrahepatic Biliary Atresia
• Three main types:
type I: Artesia limited to CBD
type II: Artesia of the CHD
type III: Artesia of the right and left hepatic duct
Extrahepatic Biliary Atresia
Extrahepatic Biliary Atresia
• Clinical features :
- one third of patient have jaundice by birth
- In all jaundice is present
- Pruritius is severe
• Liver function showed obstructive pattern
• Treatment :
• Type I : simple roux – en – Y hepaticojejunostomy
• Type II and III: kasai procedure( portoenterostomy)
Congenital dilatation of the intra hepatic
duct
• Caroli’s disease :
- Rare condition characterized by irregular saccular
dilatation of the intrahepatic ducts
- Aetiology unknown
• Choledochal cyst
Thank You !!

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