Hwang Si Eun, Kim Ji Hyun, Bae Sang In, Rodríguez-Vázquez José Francisco, Murakami Gen, Cho Baik Hwan
Department of Surgery, Daejeon Sun Hospital, Daejeon, Korea.
Department of Anatomy, Chonbuk National University Medical School, Jeonju, Korea.
Anat Cell Biol. 2014 Dec;47(4):227-35. doi: 10.5115/acb.2014.47.4.227. Epub 2014 Dec 23.
A term "mesoesophagus" has been often used by surgeons, but the morphology was not described well. To better understand the structures attaching the human abdominal and lower thoracic esophagus to the body wall, we examined serial or semiserial sections from 10 embryos and 9 fetuses. The esophagus was initially embedded in a large posterior mesenchymal tissue, which included the vertebral column and aorta. Below the tracheal bifurcation at the fifth week, the esophagus formed a mesentery-like structure, which we call the "mesoesophagus," that was sculpted by the enlarging lungs and pleural cavity. The pneumatoenteric recess of the pleuroperitoneal canal was observed in the lowest part of the mesoesophagus. At the seventh week, the mesoesophagus was divided into the upper long and lower short parts by the diaphragm. Near the esophageal hiatus, the pleural cavity provided 1 or 2 recesses in the upper side, while the fetal adrenal gland in the left side was attached to the lower side of the mesoesophagus. At the 10th and 18th week, the mesoesophagus remained along the lower thoracic esophagus, but the abdominal esophagus attached to the diaphragm instead of to the left adrenal. The mesoesophagus did not contain any blood vessels from the aorta and to the azygos vein. The posterior attachment of the abdominal esophagus seemed to develop to the major part of the phrenoesophageal membrane with modification from the increased mass of the left fetal adrenal. After postnatal degeneration of the fetal adrenal, the abdominal esophagus might again obtain a mesentery. Consequently, the mesoesophagus seemed to correspond to a small area containing the pulmonary ligament and aorta in adults.
外科医生经常使用“食管系膜”这一术语，但对其形态描述并不完善。为了更好地理解人类腹部和下胸部食管与体壁相连的结构，我们检查了10例胚胎和9例胎儿的连续或半连续切片。食管最初包埋于一大块后间质组织中，该组织包括脊柱和主动脉。在第5周气管分叉下方，食管形成了一个肠系膜样结构，我们称之为“食管系膜”，它被不断增大的肺和胸膜腔塑形。在食管系膜的最下部观察到胸膜腹膜管的气肠隐窝。在第7周时，食管系膜被膈肌分为上部的长段和下部的短段。在食管裂孔附近，胸膜腔在上侧形成1个或2个隐窝，而左侧的胎儿肾上腺附着于食管系膜的下侧。在第10周和第18周时，食管系膜沿下胸部食管保留，但腹部食管附着于膈肌而非左肾上腺。食管系膜不包含来自主动脉和至奇静脉的任何血管。腹部食管的后部附着似乎发展为膈食管膜的主要部分，并随着左侧胎儿肾上腺质量的增加而发生改变。胎儿肾上腺出生后退化后，腹部食管可能会再次获得系膜。因此，食管系膜似乎对应于成人中包含肺韧带和主动脉的一个小区域。
