Radiology · GIT Radiology (Upper GI, Lower GI, Pneumoperitoneum)

A 55-year-old man with long-standing gastroesophageal reflux disease undergoes barium swallow. There is a smooth, symmetric, ring-like narrowing at the gastroesophageal junction at the squamocolumnar junction, with normal overlying mucosa and no evidence of shouldering or mass. This finding is most characteristic of:

  • A Adenocarcinoma of the distal esophagus
  • B Peptic stricture
  • C Schatzki ring
  • D Esophageal web
Correct answer: C. Schatzki ring

Explanation

Schatzki ring is a smooth, symmetric, ring-like mucosal narrowing at the squamocolumnar junction (GEJ) seen on barium swallow, associated with hiatal hernia and GERD. It is distinct from peptic stricture (which is longer and more irregular), adenocarcinoma (which shows shouldering, mass, or irregular narrowing), and esophageal web (which is in the upper esophagus, not at the GEJ).

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

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