Which of the following statements about the anatomic course of the esophagus is correct?

E. The esophagus deviates anteriorly and to the left as it enters the abdomen.

 DISCUSSION: Knowledge of the normal course of the esophagus is important in operative and endoscopic procedures. The cervical esophagus lies just anterior to the prevertebral fascia and courses through the neck posterior to the trachea and to the left of the midline. The cervical esophagus is therefore more readily approached surgically through a left neck incision. The thoracic esophagus enters the posterior mediastinum posterior to the aortic arch. Therefore, when operating on the upper esophagus, a right thoracotomy is preferred, since the aortic arch overlies the esophagus in the left chest. The esophagus descends in the posterior mediastinum behind the left mainstem bronchus and pericardium. It is the proximity of the esophagus and left mainstem bronchus that is responsible for the development of malignant tracheoesophageal fistulas between these two structures. The esophagus enters the diaphragmatic hiatus, which is located at the level of T11. As it enters the abdomen, the esophagus deviates anteriorly and to the left. Therefore, when performing rigid esophagoscopy as the distal esophagus is entered, the patient's head must be turned to the right and the esophagoscope elevated anteriorly to avoid perforation.