Esophagus: Anatomy and Structural Anomalies
Ikuo Hirano
Northwestern University School of Medicine, Chicago, IL, USA
Search for more papers by this authorIkuo Hirano
Northwestern University School of Medicine, Chicago, IL, USA
Search for more papers by this authorDaniel K. Podolsky MD
President, University of Texas Southwestern Medical Center, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorMichael Camilleri MD
Executive Dean for Development, Atherton and Winifred W. Bean Professor, Professor of Medicine, Physiology and Pharmacology, Distinguished Investigator, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorJ. Gregory Fitz MD FAASLD
Executive Vice President for Academic Aff airs and Provost, University of Texas Southwestern Medical Center, Dean, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorAnthony N. Kalloo MD
Professor of Medicine, Johns Hopkins University School of Medicine, Director, Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorFergus Shanahan MD
Professor and Chair, Department of Medicine, Director, Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
Search for more papers by this authorTimothy C. Wang MD
Chief, Division of Digestive and Liver Diseases, Silberberg Professor of Medicine, Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorSummary
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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