THORAX-ABDOMINAL VAGUS NERVES IN FETUSES. Nervios vagos toraco-abdominales en fetos
DOI:
https://doi.org/10.31051/1852.8023.v7.n3.14188Keywords:
Vagus nerves, esophageal innervation, thoracic esophagus, anatomy, surgical anatomy, Nervios vago, inervación del esófago, esófago torácico, anatomía, anatomía quirúrgicaAbstract
Los nervios vagos han sido exhaustivamente estudiados en los adultos pero no en los niños, y mayormente en el trayecto intracraneal, más que en la periferia. El objetivo de este estudio fue proveer información más específica sobre los nervios vagos toraco-abdominales, describirlos en fetos y asociarlos con la rotación gástrica, de modo que pueda ser aplicada a procedimientos clínicos, reduciendo la morbilidad. Se disecaron treinta fetos entre 12 y 23 semanas de gestación, mayormente varones (87%), desde la parte inferior del cuello hasta el cardias, identificando los troncos y ramas de los nervios vagos. Los nervios fueron descriptos en su ingreso en el tórax en relación con las arterias carótidas, en su posición en el tercio superior del esófago asociados con el origen de las ramas cardíacas y pulmonares, en el tercio inferior del esófago con muchas variaciones en su distribución, a nivel diafragmático en el hiato esofágico y, finalmente, en relación con la posición gástrica. La discusión involucró descripciones hechas por diferentes autores incluyendo algunos estudios recientes que proporcionan resultados electrofisio-lógicos y consideraciones de aspectos clínicos, principalmente representados por procedimientos quirúrgicos y su morbilidad, ambos asociados con la lesión de los nervios vagos.
Vagus nerves have been extensively studied in adults but not in fetuses, and mostly in the intracranial pathway than the peripheral one. The objective of this study was to provide more specific information on the thorax-abdominal vagus nerves, to describe them in fetuses and to associate them with the gastric rotation, so it could be applied to clinical procedures, reducing morbidity. Thirty fetuses between 12 to 23 weeks of gestation, mainly male (87%), were dissected from the lower neck to the cardias, identifying vagus nerve trunks and braches. Vagus nerves were described at the entrance in the thorax in relation with the carotid arteries, in their position at the upper third of the esophagus associated with the origin of cardiac and pulmonary branches, in the lower third of the esophagus with many variations in their distribution, at the diaphragmatic level in the esophageal hiatus and, finally, in relation with the gastric position. The discussion involved descriptions made by different authors including some recent studies providing electrophysiological results and considerations on clinical aspects, mainly represented by surgical procedures and their morbidity associated, both to vagus nerve injury.
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