Ösophagealen

Ösophagealen describes anything relating to the esophagus, the muscular tube that conveys food from the pharynx to the stomach. In an adult, the esophagus is about 25 cm long, located behind the trachea in the mediastinum and passing through the diaphragm at the esophageal hiatus. Its walls comprise four layers: mucosa (lined by stratified squamous epithelium in the proximal and mid esophagus), submucosa with mucus-secreting glands in the distal region, a muscularis propria organized into an inner circular and an outer longitudinal muscle layer, and an adventitia (in the thoracic segment) or serosa (in the abdominal portion). The esophagus contains upper and lower sphincters; the upper sphincter, formed by the cricopharyngeus muscle, prevents air entry and retrograde flow, while the lower esophageal sphincter (LES) regulates bolus passage into the stomach and minimizes reflux.

Arterial supply comes from branches of the inferior thyroid, thoracic aorta, and left gastric arteries, with venous drainage to the azygos system and to the portal circulation via the left gastric vein. The innervation is mainly vagal, coordinating peristaltic waves and glandular secretions that lubricate the mucosa.

The primary function is the propulsion of ingested material through coordinated peristaltic contractions, aided by mucus secretion and lubrication. Disorders of the esophagus may present with dysphagia, odynophagia, chest pain, or reflux symptoms. Common conditions include gastroesophageal reflux disease (GERD), esophagitis, Barrett's esophagus, esophageal strictures, achalasia, and esophageal cancer (more often squamous cell carcinoma in the mid to proximal esophagus and adenocarcinoma at the gastroesophageal junction).

Diagnosis typically involves endoscopy with biopsy, barium radiography, high-resolution manometry, and pH monitoring. Treatments range from acid suppression and dilation to endoscopic or surgical interventions and cancer-directed therapy.