Oesophageal plexuses (anatomy)

The oesophageal plexuses are nervous plexuses formed on the surface of the oesophagus which supply the muscles and mucosa of the oesophageal wall.

The plexus is supplied by:

• sympathetic fibres:
  • to superior part of oesophagus from middle cervical ganglion
  • to the inferior part of oesophagus via the:
    • paravertebral sympathetic trunks directly
    • greater splanchnic nerves indirectly
• parasympathetic fibres:
  • to superior part of oesophagus from right vagus nerve and left recurrent laryngeal nerve
  • to inferior part of oesophagus from both right and left vagal nerves as continuations of their branches to the pulmonary plexuses
• afferent fibres; run with both autonomic divisions:
  • sympathetic supply to superior thoracic ganglia: hence, oesophageal pathology can refer pain to the upper thorax and inner arm
  • parasympathetic supply via vagus

The plexuses ramify widely as a network on the surface of the oesophagus but are most concentrated upon the anterior and posterior surfaces. This is particularly true at the inferior end of the oesophagus where the parasympathetic component is more predominant than the sympathetic part. Indeed, just proximal to the oesophagus leaving the thorax to enter the abdomen, the oesophageal plexus forms into two trunks:

• the anterior trunk - mainly fibres from the left vagus
• the posterior trunk - mainly fibres from the right vagus

However, due to the interconnections of the plexus, both trunks contain fibres from both vagal nerves.