Skip to main content
SpringerLink
Log in

Congenital Defects, Rings, and Webs

  • Chapter
Pathology of the Esophagus

Abstract

The terms heterotopia, ectopia, and chorista refer to the presence of normal structures at an unexpected site (i.e., “a displacement of parts),” and imply a congenital aberration. Although such aberrant structures occur in the esophagus, many reports of glandular or other nonsquamous structures must be eliminated on the basis of (1) being an acquired glandular metaplasia (the best example is Barrett’s esophagus) or (2) persistence of embryonic or fetal types of epithelium. In a study of 1000 esophagi from infants and children under 15, Rector and Connerly1 found aberrant mucosae in 13.2% of the cases. In their study, serial section or “jellyroll” techniques were not used, suggesting that the true incidence may have been higher. Perhaps one-half of their cases represented true mucinous cardiac glands. They mention that review of the literature reported an incidence of nonsquamous elements in the esophagus varying from 0.67% to 70%. many reports are difficult to interpret, as poor photography does not permit an independent judgment regarding the nature of the lesion.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rector LI, Connerly ML: Aberrant mucosa in the esophagus of infants and children. Arch Pathol 31: 285–295, 1941.

    Google Scholar 

  2. delaPava S, Nigogosyan G, Pickren JW, et al: Melanosis of the esophagus. Cancer 16: 48–50, 1963.

    Article  CAS  Google Scholar 

  3. Tateishi R, Taniguchi H, Wode A, et al: Argyrophil cells and melanocytes in esophageal mucosa. Arch Pathol 98: 87–89, 1974.

    PubMed  CAS  Google Scholar 

  4. Geboes K, Desmet V: Histology of the esophagus. Front Gastrointest Res 3: 1–17, 1978.

    PubMed  CAS  Google Scholar 

  5. Raeburn C: Columnar ciliated epithelium in the adult esophagus. J Pathol Bacteriol 63: 157–158, 1951.

    Article  PubMed  CAS  Google Scholar 

  6. Ming SC: In: Tumors of the Esophagus and Stomach. Atlas of Tumor Pathology, 2nd series, p 15. Washington DC: Armed Forces Institute of Pathology, 1973.

    Google Scholar 

  7. Wolff M, Rankow RM: Heterotopic gastric epithelium in the head and neck regions. Ann Plast Surg 4 (l): 53–64, 1980.

    PubMed  CAS  Google Scholar 

  8. Taylor AL: The epithelial heterotopias of the alimentary tract. J Pathol Bacteriol 30: 415–449, 1927.

    Article  Google Scholar 

  9. Salgado J A: Sebaceous glands in the esophagus. Gastrointest Endos 26 (4): 150, 1980.

    Article  CAS  Google Scholar 

  10. delaPava S, Pickren JW: Ectopic sebaceous glands in the esophagus. Arch Pathol 73: 397–399, 1962.

    CAS  Google Scholar 

  11. Merino MJ, Brand M, LiVolsi VA, et al: Sebaceous glands in the esophagus. Arch Pathol Lab Med 106: 47–48, 1981.

    Google Scholar 

  12. Anderson LS, Shackelford GB, Mancilla-Jimenez P, et al: Cartilaginous ring: A cause of esoph-ageal stenosis in infants and children. Radiology 108: 665–666, 1973.

    PubMed  CAS  Google Scholar 

  13. Sneed WF, LaGuarde DE, Kogutt MS, et al: Esophageal stenosis due to cartilaginous and tracheobronchial remnants. J Pediatr Surg 14: 786–788, 1979.

    Article  PubMed  CAS  Google Scholar 

  14. Plachta A: Benign tumors of the esophagus. Review of the literature and report of 99 cases. Am J Gastroenterol 38: 639–652, 1962.

    PubMed  CAS  Google Scholar 

  15. Shamma’a MH, Benedict EB: Esophageal webs. A report of 58 cases and an attempt at classification. N Engl J Med 259: 378–384, 1958.

    Article  PubMed  Google Scholar 

  16. Paterson DR: Clinical type of dysphagia. J Laryngol Rhinol Otol 34: 289–291, 1919.

    Google Scholar 

  17. Kelly HB: Spasm at the entrance to the esoph-agus. J Laryngol Rhinol Otol 34: 285–289, 1919.

    Google Scholar 

  18. Hoover WB: The syndrome of anemia, glossitis and dysphagia. N Engl J Med 213 (2): 394–398, 1935.

    Article  Google Scholar 

  19. Anderson HA, Sanderson DR, In: The Esophagus. Payne WS, Olsen AM (eds), pp 147–150. Philadelphia: Lea & Febiger, 1974.

    Google Scholar 

  20. Wynder EL, Fryer JN: Etiologic considerations of Plummer-Vinson (Patterson-Kelly) syndrome. Ann Int Med 49 (2): 1106–1128, 1958.

    PubMed  CAS  Google Scholar 

  21. Spiro HM: Clinical Gastroenterology, Chapter 6, pp 86–88. London: Collier-Macmillan, Limited, 1970.

    Google Scholar 

  22. Chisholm M, Ardran GM, Callender ST, et al: A followup study of patients with post-cricoid webs. J Med 40: 409–420, 1971.

    CAS  Google Scholar 

  23. McBride MJ: Dysphagia and esophageal web in sideropenic anemia. Proc R Soc Med 65: 878–880, 1972.

    Google Scholar 

  24. Vinson PP: Hysterical dysphagia. Minn Med 5: 107–108, 1922.

    Google Scholar 

  25. Suzman MM: Syndrome of anemia, glossitis and dysphagia—Report of eight cases with special reference and observations at autopsy in one instance. Arch Intern Med 51: 1–21, 1933.

    Google Scholar 

  26. McGee LC, Goodwin TM: The syndrome of dysphagia and anemia. Ann Intern Med 11: 1498–1505, 1938.

    Google Scholar 

  27. MacMillan AS: Statistical study of diseases of the esophagus. Surg Gynecol Obstet 60: 394–403, 1935.

    Google Scholar 

  28. Nosher JL, Campbell WL, Seamon WB: The clinical significance of cervical esophageal and hypopharyngeal webs. Radiology 117: 45–47, 1975.

    PubMed  CAS  Google Scholar 

  29. Seamon WB: The case of the esophageal web. Hosp Pract 12 (1): 134–135, 1977.

    Google Scholar 

  30. Maclean AD, Houghton-Allan BW: Upper esophageal web in childhood. Pediatr Radiol 3: 240–241, 1975.

    Article  PubMed  CAS  Google Scholar 

  31. Benedict EB, Lever WF: Stenosis of the esophagus in benign mucosa pemphigus. Ann Otol Rhinol Laryngol 61: 1120–1123, 1952.

    PubMed  CAS  Google Scholar 

  32. Gedde-Dahl T Jr: Epidemolysis bullosa: A clinical, genetic, and epidemiologic study, pp 78–79. Baltimore: The Johns Hopkins Press, 1971.

    Google Scholar 

  33. Azimi F, O’Harra E: Congenital intraluminal web of the esophagus with tracheoesophageal fistula. Am J Dis Child 125: 92–95, 1973.

    PubMed  CAS  Google Scholar 

  34. Liebman WM, Samloff M: Congenital membranous stenosis of the mid-esophagus—A case report and literature survey. Clin Pediatr 12: 660–662, 1973.

    CAS  Google Scholar 

  35. Longstreth GF, Wolochow DA, Tu RT: Double congenital esophageal webs in adults. Dig Dis Sci 24 (1): 162–165, 1979.

    Article  PubMed  CAS  Google Scholar 

  36. Ikard RW, Rosen HE: Mid esophageal web in adults. Ann Thorac Surg 24: 355–358, 1977.

    Article  PubMed  CAS  Google Scholar 

  37. Schatzki R, Gary JE: Dysphagia due to a diaphragm like localized narrowing in the lower esophagus (“lower esophageal ring”). Am J Roentgen Rad Ther Nucl Med 70: 911–922, 1953.

    CAS  Google Scholar 

  38. Postlethwaite RW, Musser AW: Pathology of lower esophageal web. Surg Gynecol Obstet 120: 571–575, 1965.

    Google Scholar 

  39. Goyal RK, Glancy J J, Spiro HM: Lower esophageal ring. N Engl J Med 282: 1298–1304, 1970.

    Article  PubMed  CAS  Google Scholar 

  40. Goyal RK, Bauer JL, Spiro HM: The nature and location of lower esophageal rings. N Engl J Med 284: 1175–180, 1971.

    Article  PubMed  CAS  Google Scholar 

  41. Kramer P: Location of the squamo-columnar mucosal junction. Gastroenterology 73 (1): 194 — 195, 1977.

    PubMed  CAS  Google Scholar 

  42. Laufer I: Personal communication.

    Google Scholar 

  43. Zaino L, Poppel MH, Jacobson HB, et al: The Lower Esophageal Vestibular Complex. Springfield, Illinois: Charles C Thomas, 1963.

    Google Scholar 

  44. Barrett HR: Benign stricture in the lower esophagus. J Thorac Cardiovasc Surg 43: 703–715, 1962.

    Google Scholar 

  45. Mark JBO, Goldenberg IS: Second congenital esophageal web—a sequel. J Thorac Cardiovasc Surg 48: 506–510, 1964.

    PubMed  CAS  Google Scholar 

  46. Newman SL, Caplan DB: Lower esophageal ring in childhood. Am J Gastroenterol 73: 165–167, 1980.

    PubMed  CAS  Google Scholar 

  47. Schatzki R: The lower esophageal ring. Am J Roentgenol Rad Ther Nucl Med 90 (2): 805–810, 1963.

    CAS  Google Scholar 

  48. Desai DC, Rider JA, Puletti EJ, et al: Lower esophageal ring. Gastrointest Endosc 15: 100–105, 1968.

    PubMed  CAS  Google Scholar 

  49. Bugden WF, Delmonico JE Jr: Lower esophageal web. J Thorac Surg 31: 1–15, 1956.

    PubMed  CAS  Google Scholar 

  50. Björk VO, Charonis CG: Lower esophageal web. Thorax 22: 156–164, 1967.

    Article  PubMed  Google Scholar 

  51. Salzman AJ: Lower esophageal web associated with achalasia of the esophagus. NY State J Med 65: 1922–1925, 1965.

    CAS  Google Scholar 

  52. Laufer, I: Personal communication.

    Google Scholar 

  53. Ingelfinger FJ, Kramer P: Dysphagia produced by a contractile ring in the lower esophagus. Gastroenterology 23: 419–430, 1953.

    PubMed  CAS  Google Scholar 

  54. Abel M: Mediastinal cysts. Arch Pathol 61: 360–379, 1956.

    Google Scholar 

  55. Tarney TJ, Chang CH, Nugent RG, et al: Esophageal duplication (foregut cyst) with spinal malformation. J Thorac Cardiovasc Surg 59: 293–297, 1970.

    Google Scholar 

  56. Bower R, Kiesewetter W: Mediastinal masses in infants and children. Arch Surg 112: 1003–1009, 1977.

    PubMed  CAS  Google Scholar 

  57. Voiral MW, Welsh RA, Genet EF: Esophagitis cystica. Am J Gastroenterol 59: 446–453, 1973.

    Google Scholar 

  58. Kirwin WO, Walbaum PR, McCormack RJM: Cystic intrathoracic derivatives of the foregut and their complications. Thorax 28: 424–428, 1973.

    Article  Google Scholar 

  59. Reed JC, Sobonya RE: Morphologic analysis of foregut cysts in the thorax. Am J Roentgenol Rad Ther Nucl Med 120: 851–860, 1974.

    CAS  Google Scholar 

  60. Mindelzun R, Long P: Mediastinal bronchogenic cyst with esophageal communication. Radiology 126: 28, 1977.

    Google Scholar 

  61. Salyer DC, Salyer WR, Eggleston JC: Benign developmental cysts of the mediastinum. Arch Pathol Lab Med 101: 136–139, 1977.

    PubMed  CAS  Google Scholar 

  62. Gerle RD, Jaretski A, Ashley CA, et al: Con-genital bronchopulmonary foregut malformation: Pulmonary sequestration communicating with the GI tract. N Engl J Med 278: 1413–1419, 1968.

    Article  PubMed  CAS  Google Scholar 

  63. Akiyama S, Sakamoto M, Imaizumi M, et al: Esophageal cyst: A case report and review of the literature. Jpn J Surg 10: 338–342, 1980.

    Article  PubMed  CAS  Google Scholar 

  64. Bremer JL: Diverticula and duplications of the intestinal tract. Arch Pathol 38 (2): 132–140, 1941.

    Google Scholar 

  65. Rosenthal AH: Congenital atresia of the esophagus with tracheoesophageal fistula. Report of eight cases. Arch Pathol 12: 756–772, 1931.

    Google Scholar 

  66. Brintnall ES, Kridelbaugh WW: Congenital diverticulum of the posterior hypopharynx simulating atresia of the esophagus. Ann Surg 131: 564–573, 1950.

    Article  PubMed  CAS  Google Scholar 

  67. LeRoux BT: Intrathoracic duplication of the foregut. Thorax 17: 357–362, 1962.

    Article  Google Scholar 

  68. Vaage S, Knutrud O: Congenital duplications of the alimentary tract with special regard to their embryogenesis. Prog Pediatr Surg 7: 103–123, 1974.

    Google Scholar 

  69. Chen H, Goei GS, Hertzler J: Family studies on congenital esophageal atresia with or without tracheoesophageal fistula. Annu Rev Birth Defects 15: 117–144, 1978.

    Google Scholar 

  70. Mihas AA, Slaughter RL, Goldman LN, et al: Double lumen esophagus due to reflux esophagitis with fibrous septum formation. Gastroenterology 71: 136–137, 1976.

    PubMed  CAS  Google Scholar 

  71. Cantallops JG, Adrover AO, Fernindez JM, et al: Incomplete duplication of esophagus. Endoscopy 13: 46–48, 1981.

    Article  PubMed  CAS  Google Scholar 

  72. Kassner EG, Rosen Y, Klotz DH: Mediastinal esophageal duplication cyst associated with a par¬tial pericardial defect. Pediatr Radiol 24: 53–56, 1975.

    Article  Google Scholar 

  73. Gatzinsky P, Fasth S, Hansson G: Intramural esophageal cyst with massive mediastinal bleeding. Scand J Thorac Cardiovasc Surg 12: 143–148, 1978.

    Article  PubMed  CAS  Google Scholar 

  74. Boivin Y, Cholette JP, LeFebre R: Accessory esophagus complicated by an adenocarcinoma. Can Med Assoc J 90: 1414–1417, 1964.

    PubMed  CAS  Google Scholar 

  75. Kiesewetter W: Tracheoesophageal fistula in parent and offspring: A rare occurrence. Am J Dis Child 134: 896, 1980.

    PubMed  CAS  Google Scholar 

  76. Ladd WE: The surgical treatment of esophageal atresia and tracheoesophageal fistulas. N Engl J Med 230: 625–637, 1944.

    Article  Google Scholar 

  77. Leven NL: Congenital atresia of the esophagus with tracheoesophageal fistula: Report of successful extrapleural ligation of fistulous communication and cervical esophagostomy. J Thorac Surg 10: 648–657, 1944.

    Google Scholar 

  78. Kluth D (translated by Gruderer MWL): Atlas of esophageal atresia. J Pediat Surg 11: 901–919, 1976.

    Article  PubMed  CAS  Google Scholar 

  79. Gross RE: The Surgery of Infancy and Child-hood, pp 75–102, Philadelphia: Saunders, 1953.

    Google Scholar 

  80. Swenson O, Lipman R, Fisher JH, et al: Repair and complications of esophageal atresia and trach-eoesophageal fistula. N Engl J Med 267: 960–963, 1962.

    Article  PubMed  CAS  Google Scholar 

  81. Holder TM, Ashcroft KW: Esophageal atresia and tracheoesophageal fistula. Ann Thorac Surg 9: 415–467, 1970.

    Article  Google Scholar 

  82. Ashcroft KW, Holder TM: Esophageal atresia and tracheoesophageal fistula malformations. Surg Clin North Am 56: 299–315, 1976.

    Google Scholar 

  83. Stephens, FD: In: The association and embryology of tracheoesophageal and anorectal malformations. Eishatie N, Klippel CH (eds), pp 183–188. Baltimore: Williams & Wilkins, 1981.

    Google Scholar 

  84. Weber TR, Smith W, Grosfeld JL: Surgical experience in infants with the VATER Association. J Pediat Surg 15: 849–854, 1980.

    Article  PubMed  CAS  Google Scholar 

  85. Emery JL, Haddadin A J: Squamous epithelium in the respiratory tract of children with tracheoesophageal fistula. Arch Dis Child 46: 236–242, 1971.

    Article  PubMed  CAS  Google Scholar 

  86. Maeta T, Fujiwara Y, Ohizumi T, et al: Pathological study of tracheal and pulmonary lesions in autopsy cases of congenital esophageal atresia. Tohuki J Exp Med 123: 23–32, 1977.

    Article  CAS  Google Scholar 

  87. Benjamin B, Cohen D, Glasson M: Tracheal malaria in association with congenital tracheoesophageal fistula. Surgery 79: 504–508, 1976.

    PubMed  CAS  Google Scholar 

  88. Davies MRQ, Cywes S: The flaccid trachea and tracheoesophageal congenital anomalies. J Pediat Surg 13: 363–367, 1978.

    Article  PubMed  CAS  Google Scholar 

  89. Schwartz MZ, Filler RMI: Tracheal compression as a cause of apnea following repair of trach-eoesophageal fistula: Treatment by aortoplexy. J Pediat Surg 15: 842–848, 1980.

    Article  PubMed  CAS  Google Scholar 

  90. Hicks LM, Mansfield PP: Esophageal atresia and tracheoesophageal fistula—review of 13 years experience. J Thorac Cardiovasc Surg 81: 358–363, 1981.

    PubMed  CAS  Google Scholar 

  91. Blackburn WR, Amoury RA: Congenital esophagopulmonary fistulas without esophageal atresia: An analysis of 260 cases in infants, children and adults. Rev Surg 23: 153–175, 1966.

    PubMed  CAS  Google Scholar 

  92. Rahbar A, Farha SJ: Acquired tracheoesophageal fistula. J Pediatr Surg 13: 375–384, 1978.

    Article  PubMed  CAS  Google Scholar 

  93. Dehner LP: In: Mouth, salivary glands and esophagus. Chapter 7, p 153. Pathology of Infancy and Childhood. 2nd ed, Kissane JM (ed), St. Louis: Mosby.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hospital of the University of Pennsylvania, 19104, Philadelphia, PA, USA

    Horatio Enterline (Professor of Surgical Pathology)

  2. Kaiser-Permanente Regional Laboratory, 97015, Clackamas, OR, USA

    John Thompson

Authors
  1. Horatio Enterline
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Springer-Verlag New York Inc.

About this chapter

Cite this chapter

Enterline, H., Thompson, J. (1984). Congenital Defects, Rings, and Webs. In: Pathology of the Esophagus. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-5216-0_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-5216-0_2

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-9741-3

  • Online ISBN: 978-1-4612-5216-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation