Vagal Trunks: Topographic Anatomy

Anterior (left) vagal trunk

The anterior trunk is located on the anterior surface of the abdominal esophagus. As it approaches the organ, it divides into branches supplying the anterior surface:

3–6 branches run to the esophagus, cardia, and gastric fundus;
1–3 branches pass between the layers of the lesser omentum to the liver.

The main trunk runs along the anterior aspect of the lesser curvature. Its longest branch—the left Latarjet's branch—runs toward the pyloroantral region.

Posterior (right) vagal trunk

The posterior trunk lies between the posterior surface of the esophagus and the abdominal aorta. In the region of the cardia, it divides into branches to the esophagus, as well as to the posterior surfaces of the fundus and body of the stomach.

The largest branch of this trunk runs within the lig. gastropancreaticum, located to the left of the a. gastrica sinistra, and connects with the celiac plexus. The right Latarjet's branch is the longest branch of the posterior trunk and supplies the posterior surface of the pyloroantral region.

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Additional innervation and afferent connections

Innervation also involves branches of the phrenicoabdominal nerves (rr. phrenicoabdominales), which pass through the celiac plexus.

Gastric nerves have extensive afferent connections with the nerves of neighboring organs—the liver, duodenum, and pancreas. This accounts for referred pain and functional disorders during pathologies of adjacent abdominal organs.

Briefly: answers to topical questions

Which anatomical structures form the anterior and posterior vagal trunks in the abdominal cavity from the vagus nerve trunks on the esophagus?

The anterior vagal trunk is formed from the left vagus nerve, which at the level of the lower border of the left lung root passes to the anterior surface of the esophagus and enters the abdominal cavity with it.

The posterior vagal trunk is formed from the right vagus nerve, which at the level of the lower border of the right main bronchus passes to the posterior surface of the esophagus and enters the abdominal cavity with it.

In the thoracic cavity, the right and left vagus nerves form the esophageal plexus (plexus oesophageus).

Class and exam questions

Where is the anterior vagal trunk located?

The anterior trunk is located on the anterior surface of the abdominal esophagus, and its main trunk runs along the anterior margin of the lesser curvature of the stomach.

Where does the left Latarjet's branch go?

The left Latarjet's branch is the longest branch of the anterior trunk and runs to the pyloroantral region of the stomach.

What is the posterior vagal trunk associated with in the region of the cardia?

The posterior trunk gives off a large branch that runs within the gastropancreatic ligament to the left of the left gastric artery and proceeds to the celiac plexus.

What explains the radiation of pain in diseases of the stomach or liver?

This is due to extensive afferent connections between the gastric nerves and the nerves of adjacent organs: the liver, duodenum, and pancreas.

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What else to study on this topic

Exact number and topography of branches to the esophagus and cardia
Anatomical features of the hepatic branches' course through the lesser omentum
Spatial relationship between the posterior trunk and the abdominal aorta
Detailed course of Latarjet's branches in the pyloroantral region
Structure and function of the celiac plexus in relation to the phrenicoabdominal nerves