Schatzki ring

Excerpt

A 46-year-old male presented with intermittent dysphagia to solid food lasting for 5 months. There was no history of smoking, alcohol consumption, trauma, gastroesophageal reflux or previous endoscopy. On upper gastrointestinal endoscopy a smooth ring was seen above the gastroesophageal junction (Fig. 1a). A diagnosis of Schatzki ring type B was made and the patient underwent dilatation for the same (Fig. 1b). The patient is asymptomatic at 8 months follow-up. Schatzki rings are named after Dr Richard Schatzki and are found in 6–14% of routine barium swallows [1]. Although most of the patients are asymptomatic, Schatzki rings are considered to be the most common cause of intermittent dysphagia for solids in adults [2]. The exact etiology is unclear and theories about the origin include congenital, anatomical and inflammatory factors leading to formation of a circular constriction [3]. The rings can be further subdivided into those above the gastroesophageal junction (type A) and those found at the squamocolumnar junction in the lower esophagus (type B). Recent evidence suggests that Schatzki rings may be associated with eosinophilic esophagitis, hiatus hernia or gastroesophageal reflux [4]. They are usually diagnosed by upper gastrointestinal endoscopy or barium swallow meal. Treatment is by esophageal dilatation which can be repeated if necessary [2, 3].

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