Rings and Webs
- Esophageal rings and webs are best investigated with barium radiography, endoscopy, and biopsy, and treated with esophageal dilatation with endoscopic and fluoroscopic guided Savory bougies.
- Conservative management can usually treat mild symptoms.
- Mechanical bougie dilation is the standard treatment for both esophageal rings and webs.
- Patients with Plummer-Vinson syndrome must have endoscopic mucosal surveillance and biopsy, because esophageal webs have malignant potential in this disease entity.
Rings and webs are common structural abnormalities in the esophagus. Yet there is controversy in terminology, pathogenesis, and treatment of these lesions. The terms rings and webs are often used interchangeably. Wilkins and Dreyfuss have established rings and webs as distinct entities—by structure, location, and possibly etiology. In this chapter we will continue to uphold this distinction. As with previous editions, the term ring will refer exclusively to the lower esophageal ring, better known as Schatzki’s ring.
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