Contribution Towards the Anatomy of the Esophageal Hiatus and its Relationship with the Presence of Bundles of Collagen Fibers in its Margins

DOI : http://dx.doi.org/10.4067/S0717-95022012000300015
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José Jeová de Oliveira Filho; Benedito Herani Filho; Francisco Prado Reis; Vera Lúcia Correa Feitosa & José Aderval Aragão

Summary

The aim was to detect the presence of bundles of collagen fibers in the margins of the esophageal hiatus and establish if there is any relationship of these bundles with the anatomy of the hiatus. Ten adult male cadavers, with no gross anatomical alteration caused by trauma, surgery or disease, upon the esophageal hiatus were used in the study. A piece of anatomical structure comprising the diaphragm with the esophageal hiatus and adjacent tissues was removed, dissected and 10% formol embedding. With the aid of a digital caliper, measurements of the perimeter of the esophageal hiatus were done both in the abdominal and thoracic sides. For the structural study each margin was divided in six sections. Staining techniques of Masson and Picrosirius-hematoxilin were used. Collagen fibers bundles had been found in 8/10 studied cadavers, distributed in 13 margins of the hiatus, of which 7 to left and 6 to the right. The muscle fibers originating from the right pillar had participated in forming both margins of the esophageal hiatus in 60% of cadavers, while in 40%, the fibers of the left pillar had formed the medial side of the right margin. The right margin was statistically thicker than the left. It did not have a correlation between the measures of the vertices of the angles superior/inferior and the transversal measure of the esophageal hiatus. The measures between the vertices of the angles superior/inferior, respectively, with the central tendon and median arcuate ligament, had presented thoracic values that tended to the double, in relation to the abdominal ones, and had been statistically significant. These distances were smaller in cadavers who possessed bundles of collagen fibers in the margins of the esophageal hiatus. Bundles of collagen fibers bundles were found in 65% of the 20 margins of the esophageal hiatus. The margins of the esophageal hiatus were predominantly formed by muscles fibers originated of the right pillar of the muscle diaphragm. The anatomical and morphometric data presented statistically significant values regarding: thickness of the right arm in relation to the left; distance between the vertex of the superior angle and the central tendon; and distance between the vertex of the inferior angle and the median arcuate ligament.

KEY WORDS: Diaphragm; Esophagogastric Junction; Collagen; Cadaver; Humans.

How to cite this article

FILHO, J. J. O.; FILHO, B. H.; REIS, F. P.; FEITOSA, V. L. C. & ARAGÂO, J. A. Contribution towards the anatomy of the esophageal hiatus and its relationship with the presence of bundles of collagen fibers in its margins. Int. J. Morphol., 30(3):858-865, 2012.