open access

Vol 67, No 4 (2008)
ORIGINAL ARTICLES
Published online: 2008-09-30
Submitted: 2012-02-06
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Morphologic variation of the diaphragmatic crura: a correlation with pathologic processes of the esophageal hiatus?

M. Loukas, Ch.T. Wartmann, R.S. Tubbs, N. Apaydin, R.G. Louis Jr., A.A Gupta, R. Jordan
Folia Morphol 2008;67(4):273-279.

open access

Vol 67, No 4 (2008)
ORIGINAL ARTICLES
Published online: 2008-09-30
Submitted: 2012-02-06

Abstract

The contributions of muscle fibers from the right and left diaphragmatic crura to the formation of the esophageal hiatus have been documented in several studies, none coming to a complete consensus on the number of anatomic variations or the prevalence of these variations in the human population. These variations may play a role in the pathogenicity of specific diseases that involve the esophageal hiatus, such as hiatal hernias. We examined a total of two hundred adult cadavers during 2000-2007. The variations in the diaphragmatic crura, particularly their muscular contributions to the formation of the esophageal hiatus, were grossly examined and revealed a bilateral occurrence of diaphragmatic crura in all 200 specimens. The results of the various morphological patterns of circumferential muscle fibers forming the esophageal hiatus were classified into six groups. The most common type (Type I, 45%) formed the esophageal hiatus from muscular contributions arising solely from the right crus. In Type II (20%) the esophageal hiatus was formed by muscular contributions from the right and left crura. In Type III (15%), the right and left muscular contributions arose from the right crus with an additional band from the left crus. Type IV (10%) showed that the right and left muscular contributions arose from the right crus, with two additional (anterior and posterior) bands arising from the left crus. Type V (5%) demonstrated the contributions arising solely from the left crus. In Type VI (5%) the right and left contributions originated from the left crus with two additional bands, one from the right crus and one from the left crus.
These variations may play a role in the pathogenicity of specific diseases that involve the esophageal hiatus such as hiatal hernia, gastroesophageal reflux disease and Dunbar’s syndrome.

Abstract

The contributions of muscle fibers from the right and left diaphragmatic crura to the formation of the esophageal hiatus have been documented in several studies, none coming to a complete consensus on the number of anatomic variations or the prevalence of these variations in the human population. These variations may play a role in the pathogenicity of specific diseases that involve the esophageal hiatus, such as hiatal hernias. We examined a total of two hundred adult cadavers during 2000-2007. The variations in the diaphragmatic crura, particularly their muscular contributions to the formation of the esophageal hiatus, were grossly examined and revealed a bilateral occurrence of diaphragmatic crura in all 200 specimens. The results of the various morphological patterns of circumferential muscle fibers forming the esophageal hiatus were classified into six groups. The most common type (Type I, 45%) formed the esophageal hiatus from muscular contributions arising solely from the right crus. In Type II (20%) the esophageal hiatus was formed by muscular contributions from the right and left crura. In Type III (15%), the right and left muscular contributions arose from the right crus with an additional band from the left crus. Type IV (10%) showed that the right and left muscular contributions arose from the right crus, with two additional (anterior and posterior) bands arising from the left crus. Type V (5%) demonstrated the contributions arising solely from the left crus. In Type VI (5%) the right and left contributions originated from the left crus with two additional bands, one from the right crus and one from the left crus.
These variations may play a role in the pathogenicity of specific diseases that involve the esophageal hiatus such as hiatal hernia, gastroesophageal reflux disease and Dunbar’s syndrome.
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Keywords

right crus; left crus; diaphragmatic crura; gastro-esophageal reflux disease; Dunbar’s syndrome

About this article
Title

Morphologic variation of the diaphragmatic crura: a correlation with pathologic processes of the esophageal hiatus?

Journal

Folia Morphologica

Issue

Vol 67, No 4 (2008)

Pages

273-279

Published online

2008-09-30

Bibliographic record

Folia Morphol 2008;67(4):273-279.

Keywords

right crus
left crus
diaphragmatic crura
gastro-esophageal reflux disease
Dunbar’s syndrome

Authors

M. Loukas
Ch.T. Wartmann
R.S. Tubbs
N. Apaydin
R.G. Louis Jr.
A.A Gupta
R. Jordan

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