A Study of the Vagus Nerves at the Lower End of the Esophagus, with Special Reference to Duodenal Ulcer and Acute Gastro-Duodenal Ulcerations

Abstract

Series I. A dissection of the vagus nerves at the level of the lower third of the esophagus and around the stomach was made in 151 autopsies comprising 26 cases of chronic duodenal ulcer, 9 cases of acute gastro-duodenal ulcerations, and 116 control cases. A simple vagal pattern with only one left and one right vagal trunk was found in 58 and 36 per cent of the duodenal ulcer and the control cases respectively. Statistically this difference is not significant. In 10 per cent of all cases a highly complex vagal pattern was found, without identifiable main trunks.

The diameter of the vagal trunks was significantly greater in both ulcer groups, as compared with the control group.

Series II. In 47 autopsies (8 duodenal ulcers, 5 with acute ulcerations, 34 controls) the area of a transverse section of the vagal trunks at the lower end of the esophagus was measured microscopically by taking the product of the longest and shortest diameters of the nerve sections. In a similar way the amount of nerve tissue within the perineural membrane was estimated. In cases with duodenal ulcer or acute ulcers the transverse area of the vagus nerves was significantly greater than in the control group. The amount of typical nerve tissue within the nerve was also significantly greater in the ulcer group.

Key-words:

• Duodenal ulcer
• stomach
• vagus nerve