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JSLS 2020 Apr-Jun;24(2)

Summa Health, Akron City Hospital, Akron, OH, USA.

Background And Objectives: The preoperative work up for bariatric surgery is variable and not all centers perform a preoperative upper gastrointestinal endoscopy. A study was undertaken to determine the frequency of clinically significant gross endoscopic and pathological diagnoses in a large sample of patients with obesity undergoing work-up for bariatric surgery.

Methods: Routine endoscopy was performed on all preoperative bariatric patients. Read More

J Gastroenterol Hepatol 2020 May 17;35(5):708. Epub 2019 Dec 17.

Department of Medicine, Marienhausklinik St. Josef Kohlhof, Neunkirchen, Germany.

Aten Primaria 2020 Jun - Jul;52(6):432-433. Epub 2019 Nov 10.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Móstoles, Móstoles, Madrid, España.

World J Gastroenterol 2017 Feb;23(6):1038-1043

Hafiz Hamad Ashraf, Harry Richard Dalton, Carolyn Waters, Iain Alexander Murray, Departments of Gastroenterology, Royal Cornwall Hospital NHS Trust, Truro TR1 3LJ, United Kingdom.

Aim: To determine if patients can localise dysphagia level determined endoscopically or radiologically and association of gender, age, level and pathology.

Methods: Retrospective review of consecutive patients presenting to dysphagia hotline between March 2004 and March 2015 was carried out. Demographics, clinical history and investigation findings were recorded including patient perception of obstruction level (pharyngeal, mid sternal or low sternal) was documented and the actual level of obstruction found on endoscopic or radiological examination (if any) was noted. Read More

AJR Am J Roentgenol 2015 Dec;205(6):1182-7

2 Department of Gastroenterology, Mount Auburn Hospital, Cambridge, MA.

Objective: Symptomatic lower esophageal (Schatzki) rings are one of the most common causes of dysphagia and esophageal food impaction. Although these rings are often diagnosed fluoroscopically, patients are typically referred for dilation procedures performed by a gastroenterologist. Because these procedures are invasive and carry risks, including esophageal perforation, an alternative treatment option is needed. Read More

Gastrointest Endosc 2016 May 10;83(5):1024-6. Epub 2015 Nov 10.

Tufts Medical Center, Boston, Massachusetts, USA.

Background And Aims: Schatzki rings are found in the distal esophagus, are associated with hiatal hernias, and present with intermittent dysphagia to solid foods. They can be identified by radiology (GI series or barium swallow studies) or endoscopy. Rings are not always visualized during endoscopy in patients in whom they are suspected clinically. Read More

Clin Med (Lond) 2015 Oct;15(5):477-81

University Hospitals of Leicester, Leicester, UK

Acute oesophageal symptoms include acute dysphagia or food bolus impaction (most commonly due to strictures, Schatzki ring and eosinophilic oesophagitis), acute chest pain with odynophagia due to oesophageal infections, motility disorders and acute oesophageal rupture (of which oesophageal intramural haematoma is a subtype). Acute full thickness oesophageal rupture carries a high mortality if not recognised early; the clinical features and conditions with which this may be confused are presented and discussed. Read More

Vestn Rentgenol Radiol 2015 Jan-Feb(1):5-15

Objective: To determine the importance of a symptom of Schatzki ring.

Material And Methods: The results of examining 95 patients aged 62-92 years with the symptoms of dyspepsia in the Netanya State Geriatric Center (Israel) in 1994-2004 were analyzed. Standard X-ray study of the upper digestive tract was complemented by provocation tests. Read More

Dis Esophagus 2014 Sep-Oct;27(7):607-10. Epub 2014 Feb 19.

Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts, USA.

A Schatzki ring is a submucosal, fibrotic thickening located at the gastroesophageal junction. Endoscopic treatment traditionally involves disruption of the ring. Many approaches have been described including bougies, balloons, biopsies, and diathermic monopolar incision. Read More

AJR Am J Roentgenol 2013 Nov;201(5):W678-82

1 All authors: Department of Surgery, Rutgers University/NJMS, University Hospital, 150 Bergen St, E-401, PO Box 1709, Newark, NJ 07101-1709.

Objective: The Schatzki ring was named for Richard Schatzki, a renowned radiologist who described the entity with his colleague, John E. Gary. The purpose of this article is to shed more light on a man who made such a significant contribution and to chronicle developments concerning this important radiologic finding. Read More

World J Gastroenterol 2013 Oct;19(37):6188-92

Ashish Shah, Erica Boettcher, Marianne Fahmy, Thomas Savides, Denise Kalmaz, Department of Gastroenterology, University of California San Diego, La Jolla, CA 92093, United States.

Aim: To determine if esophageal capsule endoscopy (ECE) is an adequate diagnostic alternative to esophagogastroduodenoscopy (EGD) in pre-bariatric surgery patients.

Methods: We conducted a prospective pilot study to assess the diagnostic accuracy of ECE (PillCam ESO2, Given Imaging) vs conventional EGD in pre-bariatric surgery patients. Patients who were scheduled for bariatric surgery and referred for pre-operative EGD were prospectively enrolled. Read More

World J Gastroenterol 2012 Dec;18(47):6960-6

Department of Gastroenterology, German Diagnostic Clinic, D-65191 Wiesbaden, Germany.

Aim: To investigate endoscopic findings in patients with Schatzki rings (SRs) with a focus on evidence for eosinophilic esophagitis (EoE).

Methods: We consecutively approached all adult patients scheduled for elective outpatient upper endoscopy for a variety of indications at the German Diagnostic Clinic, Wiesbaden, Germany between July 2007 and July 2010. All patients with endoscopically diagnosed SRs, defined as thin, symmetrical, mucosal structures located at the esophagogastric junction, were prospectively registered. Read More

Pediatr Radiol 2012 Dec 11;42(12):1437-40. Epub 2012 Aug 11.

Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., ML 5031, Cincinnati, OH 45229, USA.

Background: A Schatzki ring (SR) is an uncommon finding in children. Entities previously associated with an SR include gastroesophageal reflux (GER), hiatal hernia (HH) and eosinophilic esophagitis (EE).

Objective: The purpose of this study was to evaluate the overall incidence of SR and the frequency of the different entities associated with SR in the pediatric population. Read More

J Dig Dis 2012 Jun;13(6):304-9

Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Objective: We aimed to determine the prevalence of eosinophilic esophagitis (EoE) and define its clinical and endoscopic characteristics in Chinese patients.

Methods: Esophageal specimens obtained from January 2006 to December 2010 in the First Affiliated Hospital of Sun Yat-sen University were reviewed, and the data on clinical characteristics and endoscopic findings of patients were obtained. Patients with eosinophils ≥15 per high power field (HPF) were identified as having EoE. Read More

World J Gastroenterol 2011 Jun;17(23):2838-43

Department of Gastroenterology, German Clinic for Diagnostics Wiesbaden, 65191 Wiesbaden, Germany.

Aim: To study, whether the association of Schatzki rings with other esophageal disorders support one of the theories about its etiology.

Methods: From 1987 until 2007, all patients with newly diagnosed symptomatic Schatzki rings (SRs) were prospectively registered and followed. All of them underwent structured interviews with regards to clinical symptoms, as well as endoscopic and/or radiographic examinations. Read More

Dysphagia 2012 Mar 15;27(1):101-5. Epub 2011 Jun 15.

Division of Gastroenterology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.

Dysphagia is a common problem and an indication for upper endoscopy. There is no data on the frequency of the different endoscopic findings and whether they change according to demographics or by single versus repeat endoscopy. To determine the prevalence of endoscopic findings in patients with dysphagia and whether findings differ in regard to age, gender, ethnicity, and repeat procedure. Read More

Frontline Gastroenterol 2011 Apr 12;2(2):117-123. Epub 2011 Jan 12.

Background: Upper oesophageal webs or rings have rarely been reported in association with heterotopic gastric mucosa (HGM).

Objective: To describe the finding of oesophageal webs in association with HGM.

Design: Small case series. Read More

Dtsch Med Wochenschr 2010 May 19;135(21):1061-6. Epub 2010 May 19.

Medzinische Klinik C, Klinikum der Stadt Ludwigshafen, Ludwigshafen.

Background And Objective: Benign non-peptic esophageal stricture (BNES) is a rare condition in routine clinical practice. The distribution of different diseases causing BNES is not known and the efficacy and safety of endoscopic treatment in this setting has not been established.

Patients And Methods: All patients with BNES undergoing endoscopic treatment at our hospital between 2000 and 2006 were assessed retrospectively and questioned by telephone. Read More

Arch Otolaryngol Head Neck Surg 2009 Aug;135(8):781-3

Department of Otolaryngology, Center for Voice and Swallowing Disorders,Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA.

Objective: To describe the safety of transnasal balloon dilation of the esophagus.

Design: Retrospective case series.

Setting: Two tertiary care institutions. Read More

Dysphagia 2005 ;20(4):273-7

Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Syncope caused by swallowing-induced cardiac arrhythmia is an uncommon condition. The recognition of this syndrome is paramount but often difficult. We report three cases of deglutition syncope evaluated at our institution over a three-year period. Read More

Dis Esophagus 2005 ;18(1):4-16

Department of Surgery, Esophagus Division, Escola Paulista de Medicina, Unifesp, Rua Napoleão de Barros, 715 2 andar, São Paulo, SP, Brazil.

Eponyms in medicine are frequently criticized because they may not represent the person who first described a syndrome or disease. Although eponyms are very commonly used, most readers are probably unaware of who it was that named the diseases and whether the original description of the disease still corresponds to the modern definition. The 10 most common eponyms in esophageal diseases were revisited. Read More

Am Surg 2004 Aug;70(8):684-6

Department of Surgery, University of Tennessee-Memphis, Memphis, Tennessee, USA.

Upper endoscopy is often performed in patients undergoing bariatric procedures. Various pathologies may be found during upper endoscopy that may change treatment plans for these patients. This study tested the hypothesis that routine use of upper endoscopy is necessary before laparoscopic gastric bypass. Read More

Dig Dis Sci 2004 May;49(5):770-3

Division of Gastroenterology, Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA.

Our purpose was to determine the prevalence of Barrett's esophagus in the presence of Schatzki ring. We performed a retrospective case-control study with an endoscopic database. Barrett's esophagus was present in 3 of 409 (0. Read More

J Pediatr Gastroenterol Nutr 2004 Apr;38(4):436-41

Division of Gastroenterology, Children's Hospital Boston, and Department of Pediatrics, Harvard Medical School, Massachusetts, 02115, USA.

Objective: To describe the clinicopathologic characteristics of children with Schatzki ring and to determine if Schatzki ring is associated with eosinophilic esophagitis.

Methods: The authors report 18 adolescents with radiographically diagnosed Schatzki ring (SR). Their clinical and histologic characteristics were reviewed in a blinded fashion. Read More

Radiology 2003 Sep 17;228(3):609-13. Epub 2003 Jul 17.

Department of Clinical Pharmacology and Biostatistics, Georgetown University, Washington, DC, USA.

In the article by Schatzki published in 1963, data about the lower esophageal ring relate ring diameter to presence of dysphagia. Statistical analysis of these measurements was performed to quantify conclusions of Schatzki and to extract additional information from the data. Ring diameters in 332 patients with and without dysphagia are described in a histogram in the original article of Schatzki. Read More

Gastrointest Endosc 2002 Aug;56(2):244-8

Department of Gastroenterology, Hepatology and Nutrition, University of Utah Health Sciences Center and Veterans Affairs Medical Center, Salt Lake City, 84132, USA.

Background: Distal esophageal (Schatzki) ring is a frequent cause of dysphagia. Bougienage is generally effective but relapse is common. Outcomes for patients treated by endoscopic incision of distal esophageal rings after symptomatic relapses after bougienage are described. Read More

Am J Gastroenterol 2001 Dec;96(12):3448-9

J Pediatr Surg 2001 Sep;36(9):1397-400

Department of Surgery, Hospital Infantil Universitario "La Paz," Madrid, Spain.

Background/purpose: This report identifies a group of children in whom severe acute food bolus impaction (AFBI) was the leading symptom of gastroesophageal reflux (GER) in the absence of stricture.

Methods: The esophageal structure and function of 8 patients treated for AFBI requiring endoscopic removal of alimentary foreign bodies in 6 of them (up to 4 times in 1 case) were investigated by barium meal, esophagoscopy-biopsy, pH-metering, pull-through stationary manometry, and 24-hour ambulatory manometry. The results were compared with those in a group of age-matched regular refluxers (n = 14) without AFBI. Read More

Gastrointest Endosc 1999 Jul;50(1):13-7

Division of Gastroenterology and Hepatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.

Background: The optimum choice of dilator (rigid vs. balloon) for benign esophageal strictures has not been well studied. The aim of this study was to compare the immediate relief of dysphagia and the incidence of repeat dilatation within the first year with the use of either a rigid (Savary) dilator or balloon dilator for benign lower esophageal strictures. Read More

Pediatr Radiol 1998 Nov;28(11):884-6

Department of Radiology, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.

Background: The Schatzki ring is a well-known clinical and radiologic entity in adults, but is thought to be rare in childhood. Objective. To review the clinical presentations and radiologic findings of children and young adults with Schatzki rings. Read More

AJR Am J Roentgenol 1994 Jul;163(1):215

University of Washington Hospital, Seattle 98195.

South Med J 1992 Oct;85(10):946-52

Servant Institute of Radiology, Tulsa, Okla 74114.

Schatzki first reported a ring-like structure at the esophagogastric mucosal junction in 1953. There is still no uniform agreement as to its exact location, etiology, or clinical importance. We found an esophagogastric ring in 15% to 18% of 22,368 patients having routine upper gastrointestinal examinations. Read More

Am J Gastroenterol 1992 Oct;87(10):1424-8

Division of Gastroenterology, Georgetown University Hospital, Washington, DC.

Twenty-six domestic reports of suspected adverse reactions from the guar gum-containing diet pill, Cal-Ban 3000 (filed with the FDA) were reviewed. There were 18 instances of esophageal obstruction, seven instances of small bowel obstruction, and one individual who was reported to have died after ingestion of Cal-Ban 3000, but for whom insufficient details were provided to assess causation. There were 14 women and 11 men (mean age 46. Read More

Dig Dis Sci 1992 Apr;37(4):577-82

Gastroenterologisches Institut, Wiesbaden, Germany.

This study investigates the effect of a single dilation on the morphology of the lower esophageal ring and on the clinical course of symptomatic patients. Thirty-three patients were studied prospectively for a mean period of 24.3 +/- 19. Read More

Rofo 1991 Mar;154(3):252-7

Röntgenabteilung, I. Chirurgische Universitätsklinik Wien.

Benign stenoses of the oesophagus have been conventionally treated by endoscopic bougienage and were operated on in case of failure. Now that balloon catheters with large balloon diameters are available, interventional radiological dilatation of enteric strictures can be easily performed. In case of eccentric high-grade stenosis with or without blind loop, stenosis is often easier to manage and associated with less risk with an angiographic guide wire and catheter than by endoscopy. Read More

Arch Intern Med 1990 Aug;150(8):1669-72

Department of Medicine, University of Missouri School of Medicine, Columbia 65212.

Gastroesophageal reflux (GER) has been suggested as a cause of the lower esophageal (Schatzki) ring. We looked for the presence of GER and reflux injury in a series of 20 patients with lower esophageal ring and dysphagia, using a 24-hour esophageal pH monitoring and upper endoscopy with biopsy. Abnormal GER was documented in 13 of the patients (65%), 10 of whom had erosive reflux changes in the distal esophagus. Read More

Gastroenterol Clin Biol 1990 ;14(2):186-7

Am J Gastroenterol 1988 Dec;83(12):1405-8

Department of Internal Medicine, Ochsner Clinic, New Orleans, Louisiana.

We report a case of esophageal perforation that occurred in a man with a known symptomatic Schatzki ring. It is possible that the perforation may have been avoided with therapy of the lower esophageal ring. The evaluation and management of esophageal perforation are discussed. Read More

Arq Gastroenterol 1988 Apr-Jun;25(2):89-92

Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG).

A case report of a patient with Schatzki's ring which was fibrous and stenotic is presented. The treatment with a new surgical technique with good results is discussed. Read More

Ann Thorac Surg 1988 Mar;45(3):327-9

Section of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905.

Most patients with Schatzki's ring have dysphagia that can be relieved by esophageal dilation. We report an unusual case in which dysphagia caused by a Schatzki ring could not be managed conservatively. The obstructing ring was excised through a gastrotomy approached by a left-sided thoracotomy. Read More

Gastrointest Endosc 1987 Apr;33(2):96-8

In 17 ambulatory patients with severe intermittent dysphagia an endoscopic electrosurgical radial incision of a Schatzki ring was made with a modified straight retractable sphincterotome. The incision was successfully accomplished with immediate relief of dysphagia in all patients. Fourteen patients remain asymptomatic with a mean follow-up of 46 months after the first treatment. Read More

Pediatrics 1981 Dec;68(6):884-5

Gastroenterology 1980 Sep;79(3):584-5

Am J Surg 1980 Apr;139(4):591-4

Thirty-six patients with symptomatic Schatzki rings were treated by rupture of the ring and repair and followed up an average of 6 years. Thirteen (37 percent) had no recurrence of symptoms; 8 (23 percent) had recurrence of mild symtpoms; 14 (40 percent) had recurrence of symptoms as severe as those experienced preoperatively. Failure was associated with recurrence of the ring and hernia in some. Read More

Ned Tijdschr Geneeskd 1979 Aug;123(33):1425-9

Sem Hop 1979 May 8-15;55(17-18):918-24

Cancer excepted all other diseases of the esophagus are rare. Diverticula, benign tumors, perforations and the pathology of the cardia (hiatus hernia, achalasia and esophageal varices) are not studied here. We took into consideration the following diseases only: spasm of the cricopharyngeal muscle, Plummer-Vinson or Kelly-Paterson syndrome, cervical osteophytosis, dysphagia lusoria, benign and malignant mediastinal lymphatic nodes, Schatzki ring of the lower esophagus and esophageal duplications. Read More

Rofo 1978 Aug;129(2):164-8

A patient is described who suffered from prolapse of the lower oesophageal mucosa in the presence of a Schatzki ring. There was variable dysphagia culminating in total aphagia. The clinical symptoms disappeared without any treatment once the patient had overcome several years of psychological stress. Read More

Gastrointest Endosc 1975 Feb;21(3):116-8

Rev Esp Enferm Apar Dig 1974 Aug-Sep;44(2):167-74