Gastroenterology Book


Esophageal Ring

Aka: Esophageal Ring, Esophageal Web, Schatzki Ring, Esophageal A Ring, Esophageal B Ring
  1. Types: Esophageal Ring
    1. Concentric swelling of tissue (2-5 mm) that protrudes into the esophageal lumen
    2. Typically occurs in the distal esophagus, at the Lower Esophageal Sphincter (LES)
    3. Esophageal A Ring
      1. Esophageal smooth Muscle Contraction at distal esophagus (proximal to the squamocolumnar junction)
    4. Esophageal B Ring
      1. Mucosal swelling in the distal esophagus (at the squamocolumnar junction)
      2. Schatzki Ring (<12.5 mm diameter) is most common Esophageal B Ring
        1. Associated with Hiatal Hernia in most cases, as well as Eosinophilic Esophagitis
  2. Types: Esophageal Web
    1. Thin (<2 mm), asymmetric esophageal protrusion into the esophageal lumen, typically in the proximal esophagus
    2. Associated Conditions
      1. Plummer-Vinson Syndrome (Iron Deficiency Anemia, Dysphagia, cervical Esophageal Web)
      2. Zenker's Diverticulum
      3. Bullous Conditions (Epidermolysis Bullosa, Bullous Pemphigoid, Pemphigus Vulgaris)
  3. Symptoms
    1. Dysphagia for solids only
  4. Diagnosis
    1. Barium swallow (barium esophagram)
    2. Upper Endoscopy (EGD)
  5. Differential Diagnosis
    1. See Esophageal Dysphagia
  6. Management
    1. Initial approach
      1. Biopsy Esophageal Rings (exclude Eosinophilic Esophagitis)
      2. Dilatation of Esophageal Ring
      3. Proton Pump Inhibitor (e.g. Omeprazole) for 6 weeks after esophageal dilation
    2. Refractory management
      1. Various measures under endoscopy have been used (e.g. intralesional Corticosteroid, incision, laser division)
  7. References
    1. Ergon and Kahrilas in Saltzman (2020) Esophageal Rings and Webs, UpToDate, accessed 9/23/2020

Esophageal web (C0267080)

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
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

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