II. Types: Esophageal Ring
- Concentric swelling of tissue (2-5 mm) that protrudes into the esophageal lumen
- Typically occurs in the distal Esophagus, at the Lower Esophageal Sphincter (LES)
- Esophageal A Ring
- Esophageal smooth Muscle Contraction at distal Esophagus (proximal to the squamocolumnar junction)
- Esophageal B Ring
- Mucosal swelling in the distal Esophagus (at the squamocolumnar, gastroesophageal junction)
- Schatzki Ring (<12.5 mm diameter) is most common Esophageal B Ring
- Associated with Hiatal Hernia in most cases, as well as Eosinophilic Esophagitis
III. Types: Esophageal Web
- Thin (<2 mm), asymmetric esophageal protrusion into the esophageal lumen
- Extensions of mucosal and submucosal esophageal layers
- Typically in the proximal or middle Esophagus
- Associated Conditions
- Plummer-Vinson Syndrome (Iron Deficiency Anemia, Dysphagia, cervical Esophageal Web)
- Zenker's Diverticulum
- Bullous Conditions (Epidermolysis Bullosa, Bullous Pemphigoid, Pemphigus Vulgaris)
IV. Symptoms
- Dysphagia for solids only
- Food impaction may occur
V. Diagnosis
- Barium swallow (barium esophagram)
- Upper Endoscopy (EGD)
VI. Differential Diagnosis
VII. Management
- Initial approach
- Biopsy Esophageal Rings (exclude Eosinophilic Esophagitis)
- Dilatation of Esophageal Ring
- Proton Pump Inhibitor (e.g. Omeprazole) for 6 weeks after esophageal dilation
- Refractory management
- Various measures under endoscopy have been used (e.g. intralesional Corticosteroid, incision, laser division)
VIII. References
- Ergon and Kahrilas in Saltzman (2020) Esophageal Rings and Webs, UpToDate, accessed 9/23/2020
Images: Related links to external sites (from Bing)
Related Studies
| Definition (NCI) | A thin membrane that is present in the esophageal lumen. It is composed of mucosa and submucosa and it may be associated with Plummer-Vinson syndrome. |
| Concepts | Anatomical Abnormality (T190) , Disease or Syndrome (T047) |
| SnomedCT | 204657001, 22395006, 19216006 |
| English | esophagus web, esophagus webbing, esophageal web, esophageal webs, esophageal webbing, webbed esophagus, Esophageal Web, Webbed oesophagus: [congenital] or [acquired], Webbed esophagus: [congenital] or [acquired], Webbed oesophagus: [congenital] or [acquired] (disorder), web of esophagus (diagnosis), web of esophagus, Esophageal body web, Webbed esophagus, Webbed oesophagus, Oesophageal body web, Oesophageal web, Esophageal body web (disorder), Esophageal web (disorder), Esophageal web, esophagus; web, web; esophagus, Esophageal web, NOS, Oesophageal web, NOS, oesophageal web |
| Dutch | esophagus; web, web; esophagus |
| Spanish | membrana del cuerpo del esófago (trastorno), membrana del cuerpo del esófago, membrana esofágica (trastorno), membrana esofágica |
Ontology: Terminal esophageal web (C0267081)
| Concepts | Disease or Syndrome (T047) , Anatomical Abnormality (T190) |
| SnomedCT | 196612009, 235624008, 66889002 |
| English | SCHATZKI <ESOPHAGEAL> RING, LOMR - Lower oesoph mucos ring, Terminal esophageal web, SCHATZKI ESOPHAGEAL RING, schatzki's ring, esophageal rings, lower esophageal mucosal ring, ring schatzki, ring schatzkis, esophageal ring, schatzki ring, Lower oesophageal mucosal ring (disorder), Schatzki's ring, Terminal esophageal ring, Lower esophageal mucosal ring, Lower oesophageal mucosal ring, Schatzki ring, Terminal oesophageal ring, Terminal oesophageal web, LOMR - Lower esophageal mucosal ring, Esophageal ring, LOMR - Lower oesophageal mucosal ring, Oesophageal ring, SR - Schatzki ring, Terminal esophageal web (disorder), Schatzki; ring, congenital, Schatzki; ring, Schatzki, esophageal; ring, ring; Schatzki, congenital, ring; Schatzki, ring; esophageal |
| Dutch | Schatzki-ring, Schatzki; ring, congenitaal, Schatzki; ring, oesofagus; ring, ring; Schatzki, congenitaal, ring; Schatzki, ring; oesofagus |
| French | Anneau de Schatzki |
| German | Schatzki-Ring |
| Italian | Anello di Schatzki |
| Portuguese | Anel de Schatzki |
| Spanish | Anillo de Schatzki, anillo de Schatzki, anillo esofágico terminal, membrana esofágica terminal (trastorno), membrana esofágica terminal |
| Japanese | シャッキ輪, ｼｬｯｷﾘﾝ |
| Czech | Schatzkiho prstenec |
| Hungarian | Schatzki gyűrű |
Ontology: Schatzki; congenital (C1393682)
| Concepts | Congenital Abnormality (T019) |
| English | congenital; Schatzki, Schatzki; congenital |
| Dutch | Schatzki; congenitaal, congenitaal; Schatzki |
