Anatomy of the extrinsic motor nerve supply to mobilized segments of the oesophagus disrupted by dissection during repair of oesophageal atresia with distal fistula.

Atresia of the oesophagus occurs near to the site of convergence of the foregut with structures of branchial arch origin. This is a confluence of a striated muscle tube with a somatic nerve supply and a smooth muscle tube with an autonomic nerve supply. The implications, with regard to function, of denervating the oesophagus during operation are influenced by this anatomy. During dissection of a cadaver with oesophageal atresia and distal fistula, the sites of potential nerve injury were displayed. Damage to these nerves occurs during routine primary repair and may contribute to oesophageal motor dysfunction after successful surgery.