The majority of studies as to whether gastric and nongastric factors
are involved in the ‘rotation’ of the
human embryonic stomach around its longitudinal axis have been morphological.
The aim of this study was
to analyse, with morphometric support, the influence on the angular modifications
during gastric rotation of
the simultaneous changes of the gastric walls and mesenteric growth, and
the volumes of organs adjacent to
the stomach (right, left and posterior groups). Computer imaging techniques
were applied on cross sections
of a graded series of 10 human embryos (from Carnegie stage (CS) 11) and
2 fetuses. A clockwise gastric
rotation occurred during the embryonic period. The most rapid angular modifications
took place from CS
11 to 16, after the rotation became oscillatory with angular changes in
clockwise and anticlockwise
directions, reaching the highest value at CS 18 (at the supraomental part
of the stomach: 54.37°; at the
omental part: 68.03°); after this period the angular values tended
to stabilise. The predominant growth of
the left gastric wall over the right and the changes in the width of the
gastric mesentery were the most
persistent factors involved in the modifications of the transverse gastric
angle during the embryonic period
although without relationship to their direction. During the increasing
angular phases, clockwise rotation
was promoted by the decrease of the volume of any group of organs adjacent
to the stomach. When the
volume of the left and posterior groups increased simultaneously, clockwise
or anticlockwise angular
directional change was related to the respective decrease or increase adjacent
organ volume to the right. We
conclude that the stomach of the human embryo undergoes heterogeneous and
multifactorial rotation as a
consequence of the overall increase in gastric wall growth to the left
and the increase of gastric mobility
produced by the previous mesenteric enlargement, and that the rotational
direction results from the forces
exerted on the stomach and the gastric mesenteries by the adjacent organs.