The prime function of the oesophagus is the transfer of ingested food from
the pharynx to the stomach. This is facilitated by its structure. The oesophagus
traverses the posterior mediastinum to emerge through the diaphragmatic hiatus into
the abdomen. The structure, function and disorders of the diaphragm directly affect
oesophageal function. Diaphragmatic hiatal herniae, affect food transport through the
oesophagus and is one of the causes of gastro-oesophageal reflux. Chronic reflux
contributes to oesophagitis and peptic strictures.
Congenital, traction and pulsion oesophageal diverticula can also affect food transport
across the oesophagus and be responsible for dysphagia. Muscular and mucosal rings,
cysts and duplications can also affect oesophageal function and cause disordered
swallowing. Traumatic and spontaneous oesophageal injuries and perforations can be
life threatening and the emphasis is on early diagnosis, prompt resuscitation and
antibiotic cover followed by definitive surgical treatment.
Oesophageal variceal haemorrhage can be catastrophic and with significant mortality.
It tends to occur in patients with liver disease. Urgent resuscitation, evaluation and
appropriate management are all too essential. Patients should be enlisted in surveillance
and therapeutic programs to prevent further bleeds. A number of endoscopic and
surgical techniques have evolved to manage all these benign disorders of the
oesophagus.
Keywords: Benign, Structure, Function, Diaphragm, Hiatal herniae, Gastrooesophageal
reflux, Diverticula, Rings, Perforations, Varices.
