1. HISTOLOGY OF ESOPHAGUS &gastro esophageal junction
By Dr. Sobia Ibrahim
Assistant Professor Anatomy,
KEMU

2. ESOPHAGUS Is muscular tube Extends from pharynx to stomach
Wall has four layers:
Mucosa
Epithelium
Lamina propria
Muscularis interna or muscularis mucosae
Submucosa
Muscularis externa
Adventitia / Serosa

4. UPPER 1/3 OF ESOPHAGUS MUCOSA SUB-MUCOSA MUSCULARIS EXTERNA ADVENTITIA
Epithelium: Stratified squamous non-keratinized
Lamina propria: scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels
Muscularis mucosae:
Thick, smooth muscles longitudinally arranged
SUB-MUCOSA
Collagen & elastic fibres, mucous glands, blood vessels, nerves
MUSCULARIS EXTERNA
Skeletal (striated) muscles
ADVENTITIA
Collagen & elastic fibers, blood vessels

8. MIDDLE 1/3 OF ESOPHAGUS MUCOSA
Epithelium: stratified squamos non- keratinized
Lamina propria: : scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels
Muscularis mucosae:
thick, smooth muscles longitudinally
arranged
SUB-MUCOSA
Collagen & elastic fibres, mucous glands, blood vessels, nerves
MUSCULARIS EXTERNA
Skeletal (striated) muscles,
Smooth muscles
ADVENTITIA
Collagen & elastic fibers, blood & lymphatic vessels

10. LOWER 1/3 OF ESOPHAGUS MUCOSA Epithelium: Simple columnar
Lamina propria: scattered lymphocytes, few lymphatic nodules, mucous glands, blood vessels
Muscularis mucosae: thick, smooth muscles
longitudinally arranged
SUB-MUCOSA
Collagen & elastic fibres, mucous glands, blood vessels, nerves
MUSCULARIS EXTERNA
Smooth muscles
ADVENTITIA/ SEROSA
Collagen & elastic fibers, blood & lymphatic vessels

11. GASTROESOPHAGEAL REFLUX DISEASE
It is associated with incompetent barriers at this junction; caused by hiatal hernia, decrease in lower esophageal sphincter tone.
Results in reflux esophagitis as mucosal barriers are not sufficient to protect esophagus from acids, pepsin & bile
causing heart burns/atypical chest pain

12. BARRETT’S ESOPHAGUS
Reflux of gastric contents throu lower esophageal sphincter
Gastric acid in esophagus
Heart burn
With time, metaplasia of epithelium (protective)
Barrett’s esophagus
High risk for carcinoma

13. STOMACH PARTS OF STOMACH Rugae Three histological zones Cardia Fundus
Body
Pylorus
Rugae
Three histological zones

14. CARDIOESOPHAGEAL JUNCTION

15. Esophageal cardiac junction

16. MUCOSA:
1:Epithelium changes from:
Startified squamous non keratinised into simple columnar.
2: Lamina propria: esophageal cardiac glands but in stomach (cardiac, fundic and pyloric glands).
They are tubular and deep.
3:Muscularis mucosae: thick longitudinal in esophagus but thin and two layered in stomach.
Submucosa: esophageal glands proper disappear.
No glands in submucosa of stomach.
Muscularis externa: three layered in stomach an additional oblique layer is there

19. GASTROESOPHAGEAL REFLUX DISEASE
It is associated with incompetent barriers at this junction; caused by hiatal hernia, decrease in lower esophageal sphincter tone.
Results in reflux esophagitis as mucosal barriers are not sufficient to protect esophagus from acids, pepsin & bile
causing heart burns/atypical chest pain