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Esophageal rings and webs

Gulchin A Ergun, MD
Peter J Kahrilas, MD
Section Editor
John R Saltzman, MD, FACP, FACG, FASGE, AGAF
Deputy Editor
Shilpa Grover, MD, MPH, AGAF


Esophageal rings and webs are thin, typically delicate structures that partially or completely occlude the esophageal lumen. Patients with esophageal rings or webs typically present with dysphagia to solids. The majority of esophageal rings and webs can be treated endoscopically.

The pathogenesis, clinical manifestations, diagnosis, and treatment of esophageal rings and webs will be reviewed here, with a focus on Schatzki rings. The approach to patients with dysphagia and esophageal strictures is discussed elsewhere. (See "Overview of dysphagia in adults" and "Management of benign esophageal strictures".)


Esophageal ring — Esophageal rings are found in the distal esophagus. Typically, they are mucosal structures, though rarely, muscular rings are seen. Schatzki rings (a subset of B rings) are the most common type of esophageal ring.

Esophageal rings are most clearly identified on barium esophagram [1]:

A ring – Muscular ring located in the distal esophagus just proximal to the squamocolumnar junction corresponding to the strongest part of the lower esophageal sphincter. Hence, an A ring is caused by normal smooth muscle contraction in the esophagus. When hypertrophic, an A ring is called a muscular ring. These are rare and are usually seen in children. The caliber of a muscular ring changes during peristalsis, distinguishing it from a peptic stricture or mucosal ring.


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Literature review current through: Feb 2017. | This topic last updated: Jan 22, 2016.
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