Phrenoesophageal ligament re-visited

The phrenoesophageal ligament, attaching the esophagus to the diaphragm, ha s been given little emphasis in anatomy teaching. This study was undertaken to examine the macroscopic and microscopic structure of the phrenoesophage al ligament. The results indicate that the ligament is a distinct structure bridging the space between the esophageal wall and the margins of the esop hageal hiatus. This ligament appears to arise from both the endothoracic fa scia and the transversalis fascia and is composed of abundant collagen and elastic lamellae. Toward the wall of the esophagus, the ligament divides in to a prominent upper leaf and an ill-defined lower leaf before inserting in to the wall of the esophagus. Histological study reveals that the Ligament has a substantial and deep insertion into the wall of the esophagus. It app ears that the ligament plays an important role in anchoring the lower esoph agus and maintaining gastroesophageal competence. Clin. Anat. 12:164-170, 1 999. (C) 1999 Wiley-Liss.