Revision 20 for 'Schatzki ring'

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Schatzki ring

Schatzki rings (also called Schatzki-Gary rings or B-rings) are a mucosal ring in the distal esophagus that may be related to dysphagia. It is relatively common and tends to occur at the squamocolumnar junction. Depending on its luminal diameter, may be symptomatic or asymptomatic. Symptoms may range from intermittent dysphagia to complete obstruction.

Pathology

The pathogenesis of the Schatzki ring is unclear with conflicting hypotheses that include redundant pleats of mucosa, congenital abnormalities and modified peptic strictures. Interestingly, there is a reduced incidence of Barrett's esophagus in patients with a Schatzki ring.

Location

A Schatzki ring is located a few centimeters above the gastro-esophageal junction (GEJ) and is not to be confused with an esophageal A-ring which occurs at the GEJ.

Radiographic features

Fluoroscopy

On Barium swallow the following features may be seen:

  • full-column barium swallow will reveal a circumferential narrowing 3-4 cm above the GEJ
  • double contrast studies are less sensitive
  • performing a Valsalva manouver may improve sensitivity
  • barium-tablet or barium-coated marshmallow may also improve sensitivity

History and etymology

Named after Richard Schatzki (1901-92), American physician (born in Germany) 1.

Differential diagnosis

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