PubMed · 7376057
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J P Delaney. 1980. A method for esophagogastric devascularization.. https://pubmed.ncbi.nlm.nih.gov/7376057/
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A 49-year-old man was involved in a motor vehicle crash and was admitted to a local hospital. The following day, he was transferred to our hospital because of worsening dyspnea. Initial examination revealed no subcutaneous emphysema, and chest computed tomography (CT) demonstrated no mediastinal air. A left thoracentesis tube was placed for pneumothorax, which reduced the patient's respiratory distress. He had a persistent, productive cough, which worsened when he drank water. A repeat chest CT on the fifth hospital day revealed a tracheo-esophageal fistula. Bronchoscopy and esophagoscopy confirmed the diagnosis. He underwent repair of the trachea and esophagus. The ruptured membraneous portion of the trachea was closed with interrupted sutures and covered with pedicled pericardial flap. The perforated anterior esophageal wall was sutured in layers and reinforced with a fifth intercostal muscle flap. A gastrostomy tuve was placed for feeding access. Within 6 weeks, the patient recovered completely.
The human oesophagus is lined by a moist, partially keratinized, stratified squamous epithelium, one important property of which is to serve as a barrier between the outside (luminal) world and the internal world of the organism. This phenomenon in clinical parlance is known as 'oesophageal mucosal resistance'. This article details the structure and functions of the oesophageal mucosa that contribute to its defence against injury upon exposure to refluxed gastric acid.
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