Watanabe Y, Lister J
First Department of Surgery, Nagoya University School of Medicine, Japan.
Surg Today. 1993;23(8):722-7. doi: 10.1007/BF00311712.
The structural development of the phreno-esophageal membrane was studied in 34 human fetuses ranging from 9-26 weeks of age. Horizontal and coronal sections of the lower esophagus, cardia, and diaphragm were stained with Victoria Blue and Gomori's aldehyde fuchsin to show elastic fibers, and with peracetic-aldehyde fuchsin to show pre-elastic, oxytalan, and elastic fibers, being the elastic elements. The membrane was found to be present between the lower esophagus and diaphragm at 9 weeks. The peracetic-aldehyde fuchsin stain showed many elastic elements in this membrane, but the elastic stain showed only a few elastic fibers under 13 weeks. There was no basic structural change of the membrane from 9 to 26 weeks except for an increasing number of fibers and no basic difference from the anatomical arrangement described in the adult with fibers running from the fascial covering of the undersurface of the diaphragm upwards to the esophageal adventitia. Three dimensional observation revealed that the abdominal part of the esophagus was fixed caudally by the posterior part of the membrane. These findings suggest the position-stabilizing function of this membrane and the developmental co-operation between the hiatal crus and the lower esophageal sphincter as an anti-reflux mechanism.
对34例9至26周龄的人类胎儿的膈-食管膜的结构发育进行了研究。用维多利亚蓝和Gomori醛复红对食管下段、贲门和膈肌的水平及冠状切片进行染色，以显示弹性纤维，并用过氧乙酸-醛复红显示前弹性纤维、弹力纤维和弹性纤维，它们均为弹性成分。在9周时发现该膜存在于食管下段和膈肌之间。过氧乙酸-醛复红染色显示该膜中有许多弹性成分，但弹性染色显示在13周以下只有少数弹性纤维。从9周到26周，该膜除纤维数量增加外无基本结构变化，且与成人所描述的解剖排列无基本差异，纤维从膈肌下表面的筋膜覆盖层向上延伸至食管外膜。三维观察显示食管腹部部分在尾侧被该膜的后部固定。这些发现提示该膜的位置稳定功能以及裂孔脚与食管下括约肌之间作为抗反流机制的发育协同作用。
