Anatomy

The lower esophageal constriction is formed by a combination of the lower esophageal sphincter and extrinsic pressure from the diaphragmatic hiatus. It is reached at approximately 3638 cm from the incisor teeth (Table 2.5).

Table 2.5 Lower esophageal constriction

► Approximately 36-38 cm from the incisor teeth

► Formed by the sphincter and esophageal hiatus

► Venous plexus

► Longitudinal folds with concentric luminal narrowing

The lumen of the distal esophagus again appears round and symmetrical. The lower esophageal constriction is visible in the distance (Fig. 2.18). The muscular contraction and accompanying venous plexus create a typical endoscopic picture of longitudinal folds with concentric luminal narrowing (Fig. 2.19).

Fig. 2.18a, b Distal esophagus. Views of b the lower esophageal constriction
Fig. 2.19 Cross section just above the lower esophageal constriction di = diaphragm f = fundus c = cardia a = antrum d = duodenum
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