The esophagus is a 25 cm long muscular tube that extends from the lower border of the cricoid cartilage to the stomach. It has three parts - cervical, thoracic, and abdominal. Each part has unique anatomical features and relationships. The esophagus develops from the endoderm-lined yolk sac and is completely differentiated by week 12 of gestation. It has four layers - mucosa, submucosa, muscularis propria, and adventitia. The esophagus functions to transport food from the pharynx to the stomach through peristaltic contractions.

1. Dr. Chinamilli Jaahnavi
Postgraduate
MS (Gen. surgery)

2. o Development begins in week 3 of gestation
o Derived from the endoderm lined yolk sac cavity- primitive gut
o A ventral diverticulum develops during week 3- tracheobronchial tree
o Mucosa completely differentiated by week 12
o Muscular layer develops from the mesoderm beginning in week 6 and
completely formed by week 12
o First functional swallow is seen at about week 14 and well established by
4months gestation

3.  25 cm long muscular tube
 From lower border of
cricoid to stomach
 C6 to T11
 2 curves in coronal plane
 3 constrictions

4. ESOPHAGUS is mainly studied in 3 parts:
 CERVICAL
THORACIC
ABDOMINAL
All anatomical features, pathologies, surgical approach
and management options are specific to each of
these parts.

5.  Anteriorly- trachea
 Posteriorly- prevertebral muscles an fascia
covering 6th to 8th cervical vertibrae
 Laterally- carotid sheath, lower poles of the
thyroid gland
 The thoracic duct is found on left side at C6 level

7. Very short segment of variable length
o Anteriorly- esophageal groove on
posterior surface of the liver
o Related to greater sac anteriorly
and on the left.
o Lesser sac peritoneum found on the
right side
o Closely related to the vagus nerves

8. Externally-
 Collar of Helvetius,
 Gastroesophageal fat pad
Endoscopically-
 Z line,
 Transition from smooth
lining in esophagus to
rugal folds in the stomach.
.

9.  CERVICAL PART-
Inferior thyroid artery
 THORACIC PART-
Bronchial and esophageal
branches of the descending
aorta
 ABDOMINAL PART-
Ascending branches of the left
phrenic and left gastric arteries.

10. Submucosal plexus
Periesophageal venous plexus
Esophageal veins
• CERVICAL- Inferior thyroid vein
• THORACIC- Azygos vein,
Hemiazygos veins,
Intercostal veins,
Bronchial veins
• ABDOMINAL- Left gastric vein
Porto systemic anastomosis

11. o ENTERIC NERVOUS SYSTEM-
 Auerbach’s plexus in the
intermuscular plane
 Meissner’s plexus in the
submucosal plane
o EXTRINSIC NERVOUS SYSTEM-
 Parasympathetic supply from the
vagus via recurrent laryngeal
nerves
 Sympathetic supply from thoracic
spinal cord segments

12. o Lymphatic plexuses in submucosa and
muscularis regional lymph nodes
o Cervical esophagus-
 Paratracheal,
 Deep cervical,
 Internal jugular nodes
o Thoracic part-
 Mediastinal nodes,
 Paratracheal,
 Subcarinal,
 Retro cardiac
 Infracardiac lymph nodes
 Thoracic duct.

13. 4 LAYERS
 Mucosa- stratified
squamous epithelium
 Submucosa- containing
brenners glands
 Muscularis propria- inner
circular and outer
longitudinal muscle fibres
 Adventitial layer
THERE IS NO SEROSAL LAYER ON ESOPHAGUS