Oesophagus

The oesophagus is a muscular tube that conveys food and fluids from the pharynx to the stomach.

The oesophagus is 23-37 cm long with a diameter of 1-2 cm and is divided into three parts:

The cervical oesophagus begins at the upper oesophageal sphincter, which is formed by the cricopharyngeus muscle 7.

The oesophagus then descends to the left of the midline through the neck and superior mediastinum, returning to the midline at T5, before coursing to the left of the midline once more, in the posterior mediastinum. The distal thoracic oesophagus then curves anteriorly to pass through the diaphragm into the abdominal cavity. 

The lower oesophageal sphincter, also known as the phrenic ampulla or the oesophageal vestibule, represents a 2-4 cm long dilatation between the A-ring and B-ring 7.

There are three normal oesophageal constrictions that should not be confused for pathological constrictions:

  • cervical constriction: due to cricoid cartilage at the level of C5/6
  • thoracic constriction: due to aortic arch at the level of T4/5
  • abdominal constriction: at oesophageal hiatus at T10/11

Follows arterial supply:

  • upper third: deep cervical lymph nodes
  • middle third: posterior mediastinal lymph nodes
  • lower third: left gastric and coeliac group lymph nodes
  • sympathetic trunk (sympathetic fibres)
  • vagal plexus (parasympathetic fibres)

The oesophagus is made up of five layers noting there is no serosal layer:

  • outer longitudinal muscularis propria
  • inner circular muscularis propria (in the upper 1/3 of the oesophagus this layer is composed of striated (voluntary) muscle while the lower 2/3 is smooth muscle)
  • submucosa
  • muscularis mucosae
  • mucosa
    • stratified squamous epithelium that abruptly changes to columnar epithelium in the lower oesophagus
  • modified barium swallow used to evaluate pharyngeal motility during swallowing, the procedure utilizes barium of varying consistencies given by mouth with video recording of swallowing
  • barium swallow is the main radiological method of assessing the oesophagus. Double contrast oesophagogram using gas forming crystals and barium contrast are used to distend the oesophagus and coat the mucosa

Endoscopic ultrasonography is used for evaluation of the depth of the oesophageal tumor.

  • 80% will contain air allowing for appreciation of wall if there is enough surrounding mediastinal fat
  • if collapsed will appear as round or ovoid
  • T1: isointense to muscle
  • T2: hyperintense to muscle

Useful for the staging of oesophageal cancer.

Abdominal and pelvic anatomy
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Article information

rID: 27314
Section: Anatomy
Synonyms or Alternate Spellings:
  • Esophagus
  • Oesophagus - anatomy

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