Short Œsophagus (Thoracic Stomach) and its Association with Peptic Ulceration and Cancer

The literature on short œsophagus and its relationship with peptic ulceration is reviewed, and the theories regarding this association are discussed. A theory is put forward suggesting that both congenital shortening of the œsophagus and acquired shortening due to cicatrisation following ulceration are comparatively rare, and that the majority of the cases diagnosed as short œsophagus radiologically are primarily cases of hiatus insufficiency associated with spasm of the longitudinal muscle fibres, resulting from irritation due to flow of gastric juice into the œsophagus. A lax hiatus may result either from a developmental deficiency due to delayed descent of the stomach or to a loss of elasticity of the tissues in later life. In most cases of “congenital short œsophagus”, the condition is not congenital and the œsophagus is only shortened by spasmodic contraction. Two cases of short œsophagus and cancer are added to those previously published, the date of diagnosis (September 1938) in one of them (Case 2...