Morphology of gastroesophageal junction and diaphragmatic crura in newborn cadavers

By admin

Gastroesophageal reflux is one of the most popular diseases of today. In this study, we evaluated the anatomical features of the gastroesophageal junction and its related structures in newborn cadavers.
It is evaluated whether a real abdominal part of the esophagus and a real lower esophageal sphincter exist, whether cardiac mucosa can be present even in the newborn period We also measured the angle of His and evaluated the histological features of the phrenoesophageal membrane.

The results of this study indicates that there is no intraabdominal esophagus. The oblique position of the diaphragmatic crura leads into the error that there is an intraabdominal part. We prefer to name that part as diaphragmatic part of the esophagus. Both the circular and longitudinal muscle fibers of the distal esophagus were thicker than that of the thoracic esophagus which was statistically significant. But the neuronal structures of the eosophagus were equal in all the levels of the esophagus. In histological evaluation we found both cardiac and cardiooxyntic mucosa in normal epithelium. The phrenoesophageal membrane consisted of two layers. In some cadavers some fibers originating from the lower layer passed the esophageal hiatus and joined the upper layer of the membrane. There were only collagen fibers, no elastic fibers in the membrane.
In conclusion, we found that the newborn esophagus has no intraabdominal part. It has an anatomical fixed lower esophageal sphincter with no special neuronal support. Cardiac mucosa, which is mostly accepted a pathological finding secondary to gastroesophageal reflux, was present in some newborns. Phrenoesohageal membrane was a well developed structure in newborns and it consisted of collagen fibers. In some instances some fibers originating from the lower layer of the membrane support the thoracic esophagus. While some of these findings are fixed structures, some others can mature with time to establish a more effective antireflux mechanism.

Gürsu Kıyan
Yenidoğan kadavralarında gastroözofageal bileşke ve diyafram krus morfolojisi · 2007 · 47 sayfa.
Danışman: Prof. dr. aymelek Yalın

BU araştırmanın devamına: http://tez2.yok.gov.tr/tez.htm adresinden ulaşabilirsiniz.