Esophagogastric Ring: Why and When We See It, and What It Implies: A Radiologic-Pathologic Correlation

Clinical Quiz

“…The impetus for mucosal redundancy and ring formation is esophageal shortening, produced by the contraction of the longitudinal muscle (20). The ring appears and disappears as the longitudinal muscle of the esophagus contracts and relaxes (20). In an autopsy study of four patients with a radiologic SR, a well-demarcated gastroesophageal junction was seen, and there was no fixed ring.…”

“…In an autopsy study of four patients with a radiologic SR, a well-demarcated gastroesophageal junction was seen, and there was no fixed ring. The SR could be reproduced by foreshortening the full thickness of the gastroesophageal junction (5,20,21). These two hypothesis on the pathogenesis (inflammation and plication) are not mutually exclusive.…”

“…The lack of visualization during endoscopy could be related to the possibility that not all radiologically demonstrated rings are fibrous in nature (1) or, particularly in patients with EE, that air insufflation may stent the redundant mucosa. Some authors have suggested that there are two types of SR, a more common intermittent type and a less common fixed type (20), with the former being detected almost exclusively by radiologic methods. The intermittent SR probably is produced by mucosal plication and is the type seen in our patients with EE, whereas patients with peptic esophagitis may to have the fixed type.…”

Management der Dysphagie - Sicht des Gastroenterologen

“…Die Therapie ist meist durch die diagnostische Endoskopie schon erfolgt da, damit meist die Webs eingerissen werden. In den anderen Fällen kann dies mit einer Zange oder einer leichten Bougierung erzielt werden [23].…”

Lower Esophageal (Schatzki’s) Ring: Pathogenesis, Diagnosis and Therapy

“…When a large number (22,368) of upper gastrointes tinal studies were reviewed, 15-18% had LERs. many of which were asymptomatic, but nearly all of which had an associated hia tal hernia [6]. Pathologically it appears that the ring is associated with the squamocolum nar junction with squamous mucosa proximal and columnar mucosa distal to the ring [7], Some investigators have challenged this con cept and have found the location to be more variable [8], An LER is a thin annular membrane of mucosa associated with submucosal fibrosis at the gastroesophageal junction and is occa sionally confused with a thicker and more muscular ring seen proximal to the squamocolumnar junction.…”