The oesophagus forms during the fourth week of fetal life as the primitive phaynx is divided into two by two lateral folds - the tracheo-oesophageal folds - which merge in the midline to form the tracheo-oesophageal septum. By this process, the ventral tube demarcates the eventual trachea and the dorsal tube is the primordial oesophagus.
The endoderm lining the oesophagus proliferates to fill the lumen. In the late embryo, it is recanalised by loss of cells in the centre of the lumen. This stage marks the formation of the definitive oesophageal epithelium. Excessive recanalisation can lead to diverticula.
The oesophagus is relatively short in early fetal life but grows disproportionately later. Failure of adequate growth can encourage the stomach to herniate into the thoracic cavity.
As the stomach rotates to the left during development, so it carries the oesophagus. Consequently, the left vagus nerve comes to lie anteriorly and the right vagus posteriorly on the inferior oesophagus.
Abnormal positioning of the tracheo-oesophageal septum can lead to a tracheo-oesophageal fistula.
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