Schatzki ring

Background

Schatzki ring at lower esophageal sphincter, one of four areas of natural narrowing.

• Impacted food bolus common ED complaint
• 4 areas of narrowing in the esophagus
  • Upper esophageal sphincter (cricopharyngeus muscle)
  • Aortic arch
  • L mainstem bronchus
  • Lower esophageal sphincter
• Schatzki Ring: mucosal or muscular tissue ring

Clinical Features

• Dysphagia with solid foods
• Food sticking sensation with swallowing
• Crushing chest pain with complete bolus obstruction
  • "Steakhouse syndrome"

Differential Diagnosis

Dysphagia

• Achalasia
• Esophageal foreign body
• Schatzki Ring
• Esophageal web

Evaluation

Barium swallow with narrowing at ring

• EGD
  • Esophageal webs do not completely encircle the esophagus
• Barium swallow

Management

• No treatment for asymptomatic
• Food bolus removed with endoscopy
• Balloon dilation of symptomatic rings

See Also

Dysphagia

References

Authors

Daniel Eggeman, Neil Young, Ross Donaldson