Discuss oesophageal anatomy?

It is a muscular tube 20-25 cms in length. It begins in the neck at the lower border of the cricoids cartilage (C6 vertebra) and end by opening in the stomach at T11. So it has cervical, thoracic and abdominal portions.

Discuss the blood supply and lymphatic drainage of oesophagus?

  Blood supply Venous drainage Lymphatic drainage
Cervical oesophagus Inferior thyroid artery Brachiocephalic vein Deep cervical nodes
Thoracic oesophagus Oesophageal branches of Aorta Azygous vein Posterior mediastinal nodes
Abdominal oesophagus Oesophageal branches of left gastric artery Left gastric vein Left gastric nodes (this drains in coeliac nodes)

Discuss the lymphatics of oesophagus?

All submucosal tumours have a substantial risk of lymph node metastases. Local lymph node invasion occurs early and quickly because the lymphatics in the oesophagus are located in the lamina propria, in contrast to the rest of the gastrointestinal tract, in which they are located in the submucosa.

Discuss the histology of oesophagus?

  • Mucosa
    • Non keratinized stratified squamous epithelium
    • Lamina propria- loose network of connective tissue in which blood vessels, scattered lymphocytes, macrophages and plasma cells
    • Muscularis mucosae- thin layer of circular muscle between lamina propria and submucosa
  • Submucosa- dense network of connective tissue containing blood vessels, lymphatic channels, Meissner’s plexus and oesophageal glands
  • Muscularis propria- inner circular layer, Auerbach’s myenteric plexus and outer longitudinal layer of muscles
  • Adventitia/Fibrous coat. Oesophagus lacks a serosal layer unlike the rest of the GIT

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