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Development

• The GI tract is divided into 3 sections
• Foregut
  • Stomach and duodenum as far as Ampulla of Vater
• Midgut
  • Ampulla of Vater to junction of mid and distal transverse colon
• Hindgut
  • The distal colon
• Blood supply of the 3 sections is
  • Foregut – coeliac axis
  • Midgut – superior mesenteric artery
  • Hindgut – inferior mesenteric artery

Anatomy

• For descriptive purposes the stomach is divided into
  • Lesser curve
  • Greater curve
  • Fundus
  • Incisura angularis
  • Body
  • Pylorus

Histology

• The mucosa is simple columnar epithelium with millions of invaginations known as gastric pits
• Gastric pits lead into gastric glands which secrete gastric juice
• Mucous cells secrete acidic mucus and function as stem cells for surface mucosa
• Parietal cells secrete hydrochloric acid and intrinsic factor
• Chief cells secrete pepsinogen, an inactive form of pepsin
• Neuroendocrine cells secrete multiple hormones into the plasma
• The most important of these is gastrin

Blood supply

• Five main arteries supply the stomach
  • Left gastric
  • Right gastric
  • Right gastro-epiploic
  • Left gastro-epiploic
  • Short gastric
• The left gastric artery arises from the coeliac access
• The right gastric artery arises from the common hepatic artery
• The right gastro-epiploic artery arises from the gastroduodenal artery
• The left gastro-epiploic artery arises from the splenic artery
• The short gastric arteries are branches of the splenic artery

Lymphatic drainage

• The stomach drains into four groups of nodes
  • Hepatic group
  • Subpyloric group
  • Gastric group
  • Pancreaticolienal group

The vagus nerve

• Both vagi enter the abdomen through the oesophageal hiatus
• The left vagus nerve becomes anterior
• The right vagus nerve becomes posterior
• The anterior vagus runs along the lesser curve
• Nerve of Latarjet supplies the pylorus
• The posterior vagus supplies the coeliac ganglion

Author:  Dr Shakeeb Khan

Last updated: 05 January 2008

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