Esophageal Webs and Rings

  • J. A. Rinaldo
Part of the Handbuch der inneren Medizin book series (INNEREN, volume 3)


Web implies a thin, fragile diaphragm interrupting the esophageal lumen. Ring suggests a thicker, stronger diaphragm. However, both of these terms are often used to describe lesions that have a similar radiographic appearance. They are also used loosely to describe certain types of muscular contractions and stenoses. For these reasons, somewhat arbitrary but useful definitions have been coined to classify webs and rings (Shamma’a and Benedict, 1958; Hille-mand, 1968).


Iron Deficiency Hiatal Hernia Lower Esophageal Sphincter Iron Deficiency Anemia Radiographic Appearance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ahlbom, H. E.: Simple achlorhydric anaemia, Plummer-Vinson syndrome, and carcinoma of the mouth, pharynx and oesophagus in women. Brit. med. J. 1936 II, 331–333.Google Scholar
  2. Bauer, J. L., Goyal, R. K., Spiro, H. M.: The nature and location of the lower esophageal ring. Clin. Res. 118, 376 (1970).Google Scholar
  3. Benedict, E. B.: Forceful dilatation of the esophagus in the treatment of achalasia and lower esophageal ring. New Engl. J. Med. 272, 1337–1338 (1965).CrossRefGoogle Scholar
  4. Berridge, F. R., Friedland, G. W., Tagart, R. E. B.: Radiological landmarks at the oesophagogastric junction. Thorax 21, 499–510 (1966).PubMedCrossRefGoogle Scholar
  5. Bjork, V. O., Charonis, C. G.: Lower esophageal web. Thorax 22, 156–164 (1967).PubMedCrossRefGoogle Scholar
  6. Blendis, L. M., Kreel, L.: The aetiology of“ sideropenic ” web. Brit. J. Radiol. 38, 112–115 (1965).CrossRefGoogle Scholar
  7. Brombart, M., Hins, C.: L’anneau œsophagogastrique ou syndrome de Schatzki. Arch. Mal. Appar. dig. 54, 1049–1061 (1965).PubMedGoogle Scholar
  8. Bugden, W. F., Delmonico, J. R., Jr.: Lower esophageal web. J. thorac. cardiovasc. Surg. 31, 1–18 (1956).Google Scholar
  9. Cameron, J. A. M.: Dysphagia and anemia. Quart. J. Med. 22, 43–49 (1928).Google Scholar
  10. Cauthorne, R. T., Van Houtte, J. J., Donner, M. W., Hendrix, T. R.: Study of patients with lower esophageal ring by simultaneous cineradiography and manometry. Gastro-enterology 49, 632–640 (1965).Google Scholar
  11. Chisholm, M., Ardran, G. M., Callender, S. T., Wright, R.: A follow-up study of patients with post-cricoid webs. Quart. J. Med. 40, 409–420 (1971a).PubMedGoogle Scholar
  12. Chisholm, M., Ardran, G. M., Callender, S. T., Wright, R.: Iron deficiency and autoimmunity in post-cricoid webs. Quart. J. Med. 40, 421–433 (1971b).PubMedGoogle Scholar
  13. Clark, M. D., Rinaldo, J. A., Eyler, W. R.: Correlation of manometric and radiologic data from the esophagogastric area. Radiology 94, 261–270 (1970).PubMedGoogle Scholar
  14. Crawfurd, M. D., Jacobs, A., Murphy, B., Peters, D. K.: Paterson-Kelly syndrome in adolescence: a report of five cases. Brit. med. J. 1965 I, 693 – 695.Google Scholar
  15. Elwood, P. C., Jacobs, A., Pitman, R. G., Entwistle, C. C.: Epidemiology of the Paterson Kelly syndrome. Lancet 1964II, 716–720.Google Scholar
  16. Entwistle, C. C., Jacobs, A.: Histological findings in the Paterson-Kelly syndrome. J. clin. Path. 18, 408–413 (1965).PubMedCrossRefGoogle Scholar
  17. Friedland, G. W., Melcher, D. M., Berridge, F. R., Gresham, G. A.: Debatable points in the anatomy of the lower esophagus. Thorax 21, 487–498 (1966).PubMedCrossRefGoogle Scholar
  18. Goyal, R. K., Bauer, J. L., Spiro, H. M.: The nature and location of the lower esophageal ring. New Engl. J. Med. 284, 1175–1180 (1971).PubMedCrossRefGoogle Scholar
  19. Goyal, R. K., Glancy, J. J., Spiro, H. M.: Lower esophageal ring. New Engl. J. Med. 282, 1298–1305, 1355–1361 (1970).PubMedCrossRefGoogle Scholar
  20. Grosdidier, J., Borrelly, J.: Cure chirurgicale de l’anneau de Schatzki. Arch. Mal. Appar. dig. 57, 1041–1048 (1968).Google Scholar
  21. Harris, L. D., Kelly, J. E., Jr., Kramer, P.: Relation of the lower esophageal ring to the esophagogastric junction. New Engl. J. Med. 263, 1232–1235 (1960).PubMedCrossRefGoogle Scholar
  22. Heitman, P., Wolf, B. S., Sokol, E. M., Cohen, B. R.: Simultaneous cineradiographic manometry study of the distal esophagus. Small hiatal hernia and rings. Gastroenterology 50, 737–753 (1966).Google Scholar
  23. Hillemand, P.: L’anneau de Schatzki. Bull. Soc. Med. Hop. Paris 119, 667–669 (1968).PubMedGoogle Scholar
  24. Holinger, R. H., Johnston, K. C., Potts, W. J.: Congenital anomalies of the esophagus. Ann. Otol. (St. Louis) 60, 707–717 (1951).Google Scholar
  25. Holyoake, Y.: Dysphagia due to lower oesophageal ring. Clin. Radiol. 14, 158–162 (1963).PubMedCrossRefGoogle Scholar
  26. Ingelfinger, F. J.: The physiological background of heartburn, esophagitis and cardio-spasm. Arch, intern. Med. 105, 770–778 (1960).CrossRefGoogle Scholar
  27. Ingelfinger, F. J., Kramer, P.: Dysphagia produced by a contractile ring in the lower esophagus. Gastroenterology 23, 419–430 (1953).PubMedGoogle Scholar
  28. Jacobs, A., Cavell, I. A. J.: Pyridoxine and riboflavin status in the Paterson-Kelly syn drome. Brit. H. Haemat. 14, 153–160 (1968).CrossRefGoogle Scholar
  29. Jacobs, A., Kilpatrick, G. S.: The Paterson-Kelly syndrome. Brit. med. J. 1964 II, 79–82.Google Scholar
  30. Jones, R. F. M.: The Paterson-Brown-Kelly syndrome. Its relationship to iron deficiency anemia and postcricoid carcinoma. J. Laryng. 75, 529–561 (1961).PubMedCrossRefGoogle Scholar
  31. Kelley, M. L., Frazee, J. P.: Symptomatic mid-esophageal webs. J. Amer. med. Ass. 197, 143–146 (1966).CrossRefGoogle Scholar
  32. Kelly, A.: Spasm at the entrance to the esophagus. J. Laryng. 34, 285–289 (1919).Google Scholar
  33. Keyting, W. S., Baker, G. M., McCarver, R. R., Daywitt, A. L.: The lower esophagus. Amer. J. Roentgenol. 84, 1070–1075 (1960).PubMedGoogle Scholar
  34. Mendl, K., Evans, C. J.: Incomplete lower esophageal diaphragm. Brit. J. Radiol. 35, 165–171 (1962).PubMedCrossRefGoogle Scholar
  35. Miller, J. D.R., Lewis, R. B.: Esophageal webs in man. Radiology 81, 498–501 (1963).PubMedGoogle Scholar
  36. Moersch, H. J., Conner, H. M.: Hysterical dysphagia. Arch. Otolaryng. 4, 112–119 (1926).CrossRefGoogle Scholar
  37. Monges, H., Dor, J., Payan, H., Monges, A., Haney, A.: Considerations sur l’image radiologique d’anneau de l’œsophage inférieur (lower esophageal ring) et son interpretation. Arch. Mal. Appar. dig. 53, 1291–1302 (1964).PubMedGoogle Scholar
  38. Mossberg, S. M.: Lower esophageal ring treated by pneumatic dilation. Gastroenterology 48, 118–121 (1865).Google Scholar
  39. Paterson, D. R.: A clinical type of dysphagia. J. Laryng. 34, 289–291 (1919).Google Scholar
  40. Pitman, R. G., Fräser, G. M.: The post-cricoid impression on the esophagus. Clin. Radiol. 16, 34–39 (1965).PubMedCrossRefGoogle Scholar
  41. Postlethwait, R. W., Musser, A. W.: Pathology of lower esophageal web. Surg. Gynec. Obstet. 120, 571–575 (1965).PubMedGoogle Scholar
  42. Riegel, N.: Pneumatic dilatation in lower esophageal ring. N.Y. J. Med. 67, 1081–1084 (1967).Google Scholar
  43. Rinaldo, J. A., Jr.: The lower esophageal ring. Gastroenterology 51, 1093–1094 (1966).PubMedGoogle Scholar
  44. Rinaldo, J. A., Jr.: Movement of the distal esophagus during swallowing; a clue to cineradiographic and manometric examination. In: The esophagus and stomach, ed. E.Polish, p. 47–53. New York: Grune and Stratton 1967.Google Scholar
  45. Rinaldo, J. A., Jr., Gahagan, T.: The narrow lower esophageal ring: Pathogenesis and physiology. Amer. J. dig. Dis. 11, 257–265 (1966).PubMedCrossRefGoogle Scholar
  46. Salzman, A. J.: Lower esophageal web associated with achalasia of the esophagus. N.Y. J. Med. 65, 1922–1925 (1965).Google Scholar
  47. Savary, M.: La jonction muqueuse gastro-œsophagienne: Aspect endoscopique normal et pathologique. Rev. méd. Suisse rom. 90, 25–36 (1970).PubMedGoogle Scholar
  48. Savilahti, M.: On pathologic anatomy of Plummer-Vinson syndrome. Acta med. scand. 125, 40–45 (1946).CrossRefGoogle Scholar
  49. Schatzki, R.: The lower esophageal ring. Long term follow-up of symptomatic and asymptomatic rings. Amer. J. Roentgenol. 90, 805–810 (1963).PubMedGoogle Scholar
  50. Shamma’a, M. H., Benedict, E. B.: Esophageal webs. New Engl. J. Med. 259, 378–384 (1958).CrossRefGoogle Scholar
  51. Sotgiu, G., Labo, G.: Syndrome de Kelly-Paterson (formes frustes). Gastroenterologia (Basel) 86, 167–173 (1956).CrossRefGoogle Scholar
  52. Vinson, P. P.: Hysterical dysphagia. Minn. Med. 5, 107–108 (1922).Google Scholar
  53. Waldenström, J., Kjellberg, S. R.: The roentgenological diagnosis of sideropenic dysphagia (Plummer-Vinson’s syndrome). Acta radiol. (Stockh.) 20, 618–638 (1939).CrossRefGoogle Scholar
  54. Wiggins, C. A.: The lower esophageal ring. Austr. Radiol. 11, 140–149 (1967).CrossRefGoogle Scholar
  55. Wilkins, E. W., Jr., Bartlett, M. K.: Surgical treatment of the lower esophageal ring. New Engl. J. Med. 268, 461–464 (1963).PubMedCrossRefGoogle Scholar
  56. Wolf, B. S., Heitman, P., Cohen, B. R.: The inferior esophageal sphincter, the manometric high pressure zone and hiatal incompetence. Amer. J. Roentgenol. 103, 251–276 (1968).PubMedCrossRefGoogle Scholar
  57. Wynder, E. L., Fryer, J. H.: Etiologic considerations of Plummer-Vinson (Paterson Kelly) syndrome. Ann. intern. Med. 49, 1106–1128 (1958).PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag, Berlin · Heidelberg 1974

Authors and Affiliations

  • J. A. Rinaldo

There are no affiliations available

Personalised recommendations