Der angiomuskul�re Dehnverschlu� der terminalen Speiser�hre

Stelzner, F.; Lierse, W.

doi:10.1007/bf01439741

Cited by 75 publications

(9 citation statements)

References 15 publications

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“…Most of the esophageal varices rupture at or just above the gastroesophageal junction [54,84]. Variceal pressure at this point is presumably identical or only slightly inferior to portal pressure, while the intraesophageal pressure probably comes close to the relatively low intrathoracic pressure.…”

Section: Hemodynamic Parametersmentioning

confidence: 93%

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

et al. 1986

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Summary. Prophylaxis of bleeding from esophageal varices is a very tempting concept at first glance, especially under the assumption of a high mortality associated with first variceal hemorrhage. Up to now four different measures have been tried for prophylaxis: portacaval shunt operation, devascularization procedures, sclerotherapy, and drugs. With the exception of portacaval shunts, ongoing controlled trials show a weak trend toward reduction of variceal bleeding and prolongation of survival in selected patients with compensated cirrhosis and large varices. However, prophylaxis of first variceal bleeding must still be regarded as experimental and should be restricted to controlled clinical studies.

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Section: Hemodynamic Parametersmentioning

confidence: 93%

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

et al. 1986

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“…Extensive sliding movement permits the fat of omentum minus to develop a lipoma between the bursa and esophageal wall. With regard to the known specific muscle architecture of esophagus (Stelzner, 1968) the upward tilting of the plane of entry is followed by the opening of the cardia and by reflux. The bursa enlarges the postural change of the plane of entry.…”

mentioning

confidence: 99%

“…Die L~ingsspannung der Speiser6hrenmuskulatur, deren Fasern mit der Muskelarchitektur des Magens verwoben sind, stellt beim Menschen und bei dem Versuchstier Hund den bedeutsamsten Faktor f/Jr den AbschluB im Kardiabereich dar (Stelzner, 1968). Diese Feststellung dfirfen wit aufgrund eigener Untersuchungen treffen .…”

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Die Bedeutung der Bursa infracardiaca f�r die Pathogenese der Hiatusgleithernie

Kunath

1977

Langenbecks Arch Chiv

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For the first time, the capillary space-bursa infracardiaca-which is present in human evolution, is investigated and described in reference to the pathogenesis of sliding hiatal hernia. This bursa at the right dorsal wall of the esophagus can obliterate, persist or even communicate with the bursa omentalis. It supports the cranially sliding movement of the gastroesophageal junction and reduces the slope posture of the plane of esophageal entry into the stomach. Extensive sliding movement permits the fat of omentum minus to develop a lipoma between the bursa and esophageal wall. With regard to the known specific muscle architecture of esophagus (Stelzner, 1968) the upward tilting of the plane of entry is followed by the opening of the cardia and by reflux. The bursa enlarges the postural change of the plane of entry. It can be considered as a disposing factor in the development of sliding hiatal hernia. This is evaluated by a lot of observations and with regard to former experiments.

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“…Am Eingang des Oesophagus, in H6he des Ringknorpels, findet man quergerichtete Muskulatur gehfiuft, die ebenfalls als Sphincter wirkt [25,26] In dieser umschriebenen schrfigen hypoganglionfiren Zone liegen besonders weite BlutgeffiBe, die anders als im fibrigen thorakalen Teil der Speiser6hre ausgerichtet sind. Sie lassen sich bei der arteriellen Gef'fiBffillung als einzige des tubulfiren Oesophagus direkt bei der arteriellen Injektion fiber die beiden Arteriae thyreoideae inferiores ffillen.…”

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Die hypoganglion�re und die aganglion�re Hochdruckzone des oberen Oesophagus (Oesophagusmund) und ihre besondere Blutgef��versorgung (angiomuscul�rer Schn�rverschlu�)

Stelzner¹,

Lierse

Mannfrahs³

1986

Langenbecks Arch Chiv

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At the mouth of the oesophagus there is an aganglionic zone similar to that in the anorectal organ of continence. This is part of the system of permanent closure. Since the musculature at the oesophageal entrance is arranged in a screw-like fashion the aganglionic zone lies obliquely to the longitudinal axis of the oesophagus. Closure at the oesophageal entrance is further supported by a kind of corpus cavernosum similar to that in the rectum. In this pharyngeal corpus cavernosum blood is drained between the muscular fibres and their contraction prevents its drainage, thus facilitating the closure of the musculature. The constrictor pharyngeus muscle takes a similar course as does the puborectalis which leads to a bend in the anal canal. Thus also at the entrance to the gastrointestinal tract an arterial angiomuscular system of closure exists in the center of which an aganglionic segment is conspicuous.

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Der angiomuskul�re Dehnverschlu� der terminalen Speiser�hre

Cited by 75 publications

References 15 publications

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

Die Bedeutung der Bursa infracardiaca f�r die Pathogenese der Hiatusgleithernie

Die hypoganglion�re und die aganglion�re Hochdruckzone des oberen Oesophagus (Oesophagusmund) und ihre besondere Blutgef��versorgung (angiomuscul�rer Schn�rverschlu�)

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