Chapter 3

Esophagus: Anatomy and Structural Anomalies

Ikuo Hirano

Ikuo Hirano

Northwestern University School of Medicine, Chicago, IL, USA

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First published: 27 November 2015

Summary

This chapter reviews embryology and normal gross anatomy and histology of the esophagus as background pertinent to all esophageal disorders. It also covers the developmental and structural anomalies of esophagus. Owing to a shared embryological origin, congenital disorders affecting the esophagus often involve abnormalities of the respiratory tract. The chapter illustrates the five basic types of tracheoesophageal fistula (TEF) and esophageal atresia. Ring-like narrowings at the esophagogastric junction are now differentiated into two types: lower esophageal muscular ring, or A-ring, and lower esophageal mucosal ring, or B-ring. For patients demonstrating a poor or short-duration response to esophageal dilation of a presumed symptomatic lower esophageal mucosal ring, other etiologies should be sought including motility disorders and eosinophilic esophagitis. Esophageal candidiasis has been described in up to 50% of reported cases; however, its role in the development of esophageal intramural pseudodiverticulosis is unknown and it is likely secondary to stasis.

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