Functional Anatomy of the Vagus Nerves in the Upper Abdomen

Abstract

When the left lobe of the liver is retracted upward and the stomach pulled downward, the abdominal portion of the esophagus can be seen. In thin patients, in particular, the anterior vagus trunk (trunk diameter 0,3 to 6 mm) is visible, covered by its serous coat, anterior to the abdominal portion of the esophagus. The posterior vagus trunk (trunk diameter 0,2 to 7 mm) cannot be seen but can usually be palpated. If the esophagus is rotated around its longitudinal axis, the posterior vagus trunk can be seen. The opinion cited in many textbooks of anatomy and surgery, that there is only one anterior ( = left) vagus trunk and one posterior vagus ( = right) vagus trunk should be regarded skeptically. As in the description of Harkins (1962) Hrabal (1974) has stated that the following distribution of vagus trunks may be expected in the abdominal portion of the esophagus:

$$ \begin{array}{l} anterior\,\,vagus\,\,trunk:\,\,{\rm{1}}\,\,{\rm{trunk}}\,{\rm{ - }}\,{\rm{27,6\% ,}}\,\,{\rm{2}}\,\,{\rm{trunks}}\,\,{\rm{ - }}\,{\rm{27,7\% ,}}\,\,{\rm{3}}\,\,{\rm{trunks}}\,{\rm{ - }}\,{\rm{20,7\% ,}}\,\,{\rm{4}}\,\,{\rm{trunks}}\\ {\rm{13,8\% , 5}}\,\,{\rm{trunks}}\,\,{\rm{ - }}\,\,{\rm{8,5\% ,}}\,\,{\rm{and}}\,\,{\rm{6}}\,{\rm{trunks}}\,\,{\rm{ - }}\,{\rm{1,7\% ;}} \end{array} $$

$$ \begin{array}{l} posterior\,vagus\,\,trunk:\,\,{\rm{1}}\,\,{\rm{trunk}}\,\,{\rm{ - }}\,\,{\rm{40\% ,}}\,\,{\rm{2}}\,\,{\rm{trunks}}\,\,{\rm{ - }}\,\,{\rm{28,4\% ,}}\,\,{\rm{3}}\,\,{\rm{trunks}}\,\,{\rm{ - }}\,\,{\rm{18,4\% ,}}\,\,{\rm{4}}\,\,{\rm{trunks}}\\ {\rm{10\% ,}}\,{\rm{6}}\,\,{\rm{or}}\,\,{\rm{7}}\,\,{\rm{trunks}}\,\,{\rm{ - }}\,\,{\rm{3,2\% }}\,\,{\rm{(Fig}}{\rm{.1)}}{\rm{.}} \end{array} $$