Schatzki ring: Difference between revisions
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==Background== | ==Background== | ||
[[File:Gray1032.png|thumb|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]] | |||
[[File:Layers of the GI Tract english.svg|thumb|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]] | |||
[[File:Illu esophagus.jpg|thumb|Esophagus anatomy and nomenclature based on two systems.]] | |||
[[File:Schatzki ring 2.jpg|thumbnail|Schatzki ring at lower esophageal sphincter, one of four areas of natural narrowing.]] | [[File:Schatzki ring 2.jpg|thumbnail|Schatzki ring at lower esophageal sphincter, one of four areas of natural narrowing.]] | ||
*Impacted food bolus common ED complaint | *Impacted food bolus common ED complaint | ||
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==Clinical Features== | ==Clinical Features== | ||
*Dysphagia with solid foods | *[[Dysphagia]] with solid foods | ||
*Food sticking sensation with swallowing | *Food sticking sensation with swallowing | ||
*Crushing chest pain with complete bolus obstruction | *Crushing [[chest pain]] with complete bolus obstruction | ||
**"Steakhouse syndrome" | **"Steakhouse syndrome" | ||
Latest revision as of 22:24, 7 February 2024
Background
- 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
- Oropharyngeal dysphagia
- CVA
- Parkinson's disease
- Brain stem tumors
- Degenerative disease - ALS, MS, Huntington's
- Postinfectious - polio, syphilis
- Peripheral neuropathy
- Myasthenia gravis
- Polymyositis, dermatomyositis
- Muscular dystrophy
- Esophageal dysphagia
- Achalasia
- Diffuse esophageal spasm
- Ingested foreign body
- Esophageal web
- Malignancy, mediastinal masses
- Schatzki Ring
- Scleroderma
- Strictures - peptic, radiation, chemical, medication-induced
- Vascular compression
- Zenker's diverticulum
Evaluation
- 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