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May 1958

Anatomy of the Esophageal Hiatus: Anatomic Studies on Two Hundred Four Fresh Cadavers

Author Affiliations

Chief Resident in Surgery (Present address: Wolf Point, Mont.) (Dr. Listerud). Professor of Surgery and Surgeon-in-Chief (Dr. Harkins).; From the Division of General Surgery, King County Hospital and the Department of Surgery, University of Washington School of Medicine.

AMA Arch Surg. 1958;76(5):835-842. doi:10.1001/archsurg.1958.01280230175027

The surgical treatment of esophageal hiatus hernia is essentially a development of the past 25 years, largely due to the contributions of Allison, Harrington, Tanner, Sweet, and others. The type of operation to be selected is in dispute, possibly because of lack of knowledge of the anatomy of the region involved and of the variations in that anatomy. In this connection, the muscular crura of the diaphragm about the hiatus are of considerable importance. This paper will discuss these muscular crura.

Descriptions of the relationships of the crura around the esophageal hiatus as given in textbooks and atlases of anatomy are often incomplete and sometimes incorrect. One of the first descriptions of a variation in the crura was by Low, in 1907. More recently, Collis, Satchwell, and Abrams5 (1954); Collis, Kelly, and Wiley4 (1954); Carey and Hollinshead3 (1955), and Madden9 (1956) have described these variations in

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