Alerts and Notices
SynopsisEsophageal rings are thin mucosal structures, found most often in the distal esophagus, that occlude the esophageal lumen. The most common type of esophageal ring is a Schatzki ring, of which there are two types based on location: type A rings are located above the esophageal-gastric junction, and type B rings are at the distal esophagus at the squamocolumnar junction. Esophageal rings are relatively common, and can often be seen incidentally. They are observed in approximately 10% of all barium swallow tests, regardless of indication for the study.
Patients with esophageal rings often present with dysphagia to solid food, typically meat or bread. When the diameter of rings is less than 13 mm, patients may present with acute food impaction.
Although the clinical presentation can be similar, esophageal webs are caused by normal esophageal mucosa and submucosa growing in a circumferential and obstructive nature within the esophagus.
Esophageal rings are associated with a lower risk of Barrett esophagus, a precancerous condition.
Most esophageal rings can be managed endoscopically with improvement in symptoms. The most severe complications of the rings are food impactions, which require emergent upper endoscopy for food bolus disimpaction, or complications of the endoscopic procedure itself – primarily bleeding, infection, or the risk of perforation.
K22.2 – Esophageal obstruction
Q79.8 – Other congenital malformations of musculoskeletal system
66889002 – Terminal esophageal web
Differential Diagnosis & Pitfalls
- Eosinophilic esophagitis
- Peptic / esophageal stricture
- Gastric outlet obstruction
- Hiatal hernia
- Abdominal migraine
- Small bowel obstruction
- Duplication cyst
- Duodenal hematoma
- Pancreatitis (acute and chronic)
- Gastroesophageal reflux