Matstrupen

Matstrupen, or the esophagus, is a muscular tube about 25 to 30 centimeters long that transports swallowed material from the pharynx to the stomach. It runs through the neck and chest and passes the diaphragm at the esophageal hiatus. Peristaltic waves move the bolus toward the stomach, aided by coordinated relaxation of the upper and lower esophageal sphincters. The upper esophageal sphincter prevents air from entering the digestive tract, while the lower esophageal sphincter helps prevent reflux of gastric contents.

Anatomy and structure include the mucosa, submucosa and muscularis propria. The esophagus contains different muscle types along its length: the cervical portion is predominantly striated muscle, the middle portion mixed, and the distal portion mainly smooth muscle. The muscularis propria consists of an inner circular and an outer longitudinal layer. The esophagus is encased by adventitia rather than a serosa. Blood supply comes from branches of the inferior thyroid, bronchial and esophageal arteries in the thorax, and from the left gastric and left inferior phrenic arteries in the abdomen. Lymphatic drainage follows the arterial supply to deep cervical, mediastinal, celiac and gastric nodes, depending on the segment.

Nerve supply is via the vagus nerves and the enteric nervous system, which coordinate peristalsis and sphincter function. Diseases of the esophagus include gastroesophageal reflux disease (GERD), esophagitis and Barrett's esophagus, strictures and diverticula, achalasia, and esophageal cancer (primarily squamous cell carcinoma in the upper/mid esophagus and adenocarcinoma near the gastroesophageal junction). Esophageal varices can occur with portal hypertension. Diagnosis typically involves endoscopy with biopsy, barium swallow, and manometry; treatment ranges from lifestyle and acid-suppressive therapy to dilation or myotomy for motility disorders and oncologic management for cancer. Embryologically, the esophagus develops from the foregut.