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Internal Medicine

Lower esophageal Schatzki ring (SR)

Schatzki ring or Schatzki–Gary ring is a thin circular membrane of mucosa & submucosa seen at squamocolumnar junction of the distal oesophagus.

  • Does not contain any muscularis propria.
  • Upper surface covered with squamous epithelium and lower surface covered with columnar epithelium
  • Always associated with a hiatal hernia
  • M/C cause of episodic dysphagia for solids & food impactions in adults.

Subtypes:

  • A-rings: Above the oesophagus/stomach junction
  • B-rings: At the squamocolumnar junction in the lower oesophagus

History:

Richard Schatzki was a renowned radiologist who described a ring-like structure in patients with dysphagia in articles from 1953 to 1963, and that structure would later bear his name.

index
Richard Schatzki (1901–1992) was a German-American radiologist.

Clinical features

  • Asymtomatic (M/C)
  • Symptomatic: Intermittent dysphagia & food impaction

Diagnosis

Imaging

Barium swallow:


Management

Asymptomatic Schatzki rings seldom worsen over time, and need no treatment.

Symptomatic Schatzki rings:

  • Esophageal dilatation: Bougie/balloon dilator

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