That said, it must be admitted that there is something unusual and significant about such tubular HHs beside their shape. The persistent shortening of the esophagus with its attendant reflux and the small hiatus that molds them and constricts their blood supply without strangulating the stomach deserves separate classification and analysis. If the tube of stomach is constantly above the diaphragm, as may well be the case, the LM must be constantly shortened. I have not attempted to examine the claim that the incidence of carcinoma is greatly increased in such cases although this assertion deserves critical study in view of the wide disparity in reported incidence. It would be worth studying a large series of such cases for the incidence of carcinoma.
Nothing is ever simple.
There is some theoretical possibility that a congenitally short esophagus may never have developed a squamous epithelial lining during embryogenesis. Summary Longitudinal shortening of the esophagus can be due to vagal stimulation, to hormonal influences, and to the direct effect of acid pH on the esophageal mucosa. It shortens reflexly from inflation of the organ at radiologic or endoscopic examination. They cause a tubular hiatal transtract that is mistaken by examiners for esophagus lined with gastric mucosa. The supposed metaplasia can vary up to 9 cm over a few weeks or vanish entirely as more or less stomach is pulled through the diaphragm.