Esophagus
Congenital anomalies
Rings and webs
Author: Elliot Weisenberg, M.D.
Last author update: 1 January 2013
Last staff update: 12 December 2023
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Rings[TI] esophagus
Table of Contents
Definition / general | Diagrams / tables | Case reports | Treatment | Clinical imagesCite this page: Weisenberg E. Rings and webs. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophagusringsesophagus.html. Accessed April 19th, 2024.
Definition / general
- Initially described as a constant, symmetrical and diaphragm-like narrowing at the GE junction, associated with a small sliding hiatus hernia (Am J Roentgenol Radium Ther Nucl Med 1953;70:911)
- Now defined as concentric, smooth, thin (3 - 5 mm) protrusions of normal esophageal tissue (with mucosa, submucosa and muscularis propria) into the lumen (eMedicine: Esophageal Webs and Rings [Accessed 8 February 2019], eMedicine: Schatzki Ring [Accessed 8 February 2019], GI Motility Online: Pharyngeal and Esophageal Diverticula, Rings and Webs [Accessed 8 February 2019], Wikipedia: Schatzki Ring [Accessed 8 February 2019])
- Usually in distal esophagus
- May be congenital or a scar from drinking caustic liquids
- Type A: lower muscular ring; rare; thickened circular smooth muscle with overlying squamous mucosa; usually 1.5 cm proximal to squamocolumnar junction, usually asymptomatic (Am J Gastroenterol 2000;95:43)
- Type B: lower mucosal ring / Schatzki ring; 5% of normal esophagi; upper surface is lined by stratified squamous epithelium, undersurface is lined by columnar type epithelium; ring contains connective tissue and fibers of muscularis mucosae; located at squamocolumnar junction at proximal margin of hiatal hernia; associated with meat impaction ("steakhouse syndrome," Surg Endosc 1989;3:195), "swallow syncope" (Dysphagia 2005;20:273) and a reduced incidence of Barrett esophagus (Dig Dis Sci 2004;49:770)
- Type C: rare; refers to indentation on radiographic studies caused by diaphragmatic crura; usually asymptomatic
Diagrams / tables
Images hosted on other servers:
Netter drawings of A and B rings
Case reports
- 16 year old boy with Schatzki ring causing dysphagia (J Postgrad Med 1987;33:99)
- 54 year old man with dysphagia (Dis Chest 1968;54:465)
Treatment
- Dilation, possibly antireflux medical therapy or surgery (Ann Thorac Surg 1984;37:103)
Clinical images
Images hosted on other servers:
Endoscopy images:
With distal hiatal hernia
Meat (chicken) impaction
Mulitple rings
Schatzki ring
