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"Schatzki ring"

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1. Assessment of dysphagia

lateral sclerosis (ALS) Progressive supranuclear palsy Wilson's disease Tardive dyskinesia Idiopathic achalasia Nutcracker oesophagus Caustic agents Pill-induced injury Radiation exposure Oesophageal carcinoma Foreign body Benign oesophageal tumours (leiomyoma, lipoma, polyps) Oesophageal metastases Oesophageal compression Schatzki ring Gastroesophageal muscular ring Oesophageal diverticulum Eosinophilic oesophagitis Oesophageal web Botulism Oral mucositis Cervical osteophytes Contributors Authors

2018 BMJ Best Practice

2. Sirens to Scrubs: Esophageal Foreign Body Obstructions

) Psychiatric patients and prisoners Patients without teeth (they have impaired sensation within their mouth) Patients with underlying esophageal disease (i.e. strictures from chronic acid reflux, mucosal rings, such as a Schatzki ring, eosinophilic esophagitis, related to food allergies and atopic disorders, malignancy, diverticula) or other conditions that can impede passage through the esophagus (i.e. enlarged left atrium, motor neuron disorders, large goiter, mediastinal tumour Jeff has arrived awake

2018 CandiEM

3. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

with symptoms that are particularly intense or not responsive to traditional therapies in order to evaluate for anatomic abnormalities. The test can be used to evaluate for other conditions that might mimic or predispose to GERD such as hiatal hernia, malrotation, pyloric stenosis, duodenal web, duodenal stenosis, antral web, esophageal narrowing, Schatzki’s ring, achalasia, esophageal stric- ture, and esophageal extrinsic compression. One of the most important roles for barium imaging is in the evaluation

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

4. CRACKCast E089 – Esophagus, Stomach & Duodenum

, stridor, rhonchi, poor feeding Causes of esophageal obstruction: Mechanical obstruction: Internal Foreign body Adults – meat/bones; dentures; pen caps, etc. Kids – coins/batteries Strictures / rings ( Schatzki’s ring ) / webs Eosinophilic esophagitis Malignancy External factors Large Left atrium / ventricle Goiter Mediastinal tumour Motor factors (remember than the distal 2/3rds are innervated by involuntary smooth muscle) Achalasia Infectious (botulism, tetanus, etc.) Food bolus therapies: (from Ep

2017 CandiEM

5. Joint NASPGHAN and ESPGHAN guidelines on Gastro-oesophageal Reflux Disease in Children

, duodenal web, duodenal stenosis, antral web, esophageal narrowing, Schatzki’s ring, achalasia, esophageal stric- ture, and esophageal extrinsic compression. One of the most important roles for barium imaging is in the evaluation of children who have had anti-reflux surgery who are symptomatic with persistent typical or atypical reflux symptoms, dysphagia or pain; barium imaging can be helpful to differentiate an obstructing fundoplication with esophageal stasis from a slipped or loose fundoplication

2018 British Society of Paediatric Gastroenterology Hepatology and Nutrition

6. Gastroesophageal Reflux Disease (GERD)

, such as pharmacists. 3.4 Differential diagnosis • Peptic ulcer disease • Upper gut malignancy • Functional heartburn — differentiate NERD and functional heartburn on the basis of a clinical response to therapeutic acid suppression, pH monitoring, or impedance pH monitoring • Schatzki ring, stricture — esophageal web • Achalasia of the cardia • Esophageal body motility disorders — scleroderma; diffuse esophageal spasm • Eosinophilic esophagitis • Infection — Candida, herpes simplex, etc. • “Pill esophagitis

2015 World Gastroenterology Organisation

7. The role of endoscopy in the evaluation and management of dysphagia

of the stricture. The amount of radial force exerted depends on several factors, including caliber of the dilator relative to the stricture diameter, surface TABLE2. Commonetiologiesofesophagealdysphagia Common etiologies Amenable to dilation Benign etiologies Peptic stricture Yes Schatzki ring Yes Esophageal web Yes Eosinophilic esophagitis Yes Caustic injury Yes Anastomotic stricture Yes Radiation injury Yes Pill-induced stricture Yes Post-endoscopic therapy stricture Yes Congenital esophageal anomalies (...) is then performed. After moderate resistance is encountered, typically no greater than 3 consecutive dilators in increments of 1 mm are passed in a single session. The “rule of 3” does not apply to balloon dilation, and in?ation of a single, appropriately sized balloon dilator should be done. Incremental dilations ofO3 mm may be safe for simple strictures. 53-55 Schatzki ring Dilation with a single, large (16 mm to 20 mm) dilator leads to rupture of the Schatzki ring, and symptomatic re- liefinalmost

2014 American Society for Gastrointestinal Endoscopy

8. Modifications in endoscopic practice for pediatric patients

. THERAPEUTIC PROCEDURES IN CHILDREN Esophageal strictures in children are usually nonmalig- nant and include narrow anastomoses after surgical repair of esophageal atresia, peptic injury, eosinophilic esophagi- tis, congenital lesions, Schatzki’s rings, achalasia, and caustic injury. 103,104 Strictures can also be found in the proximal or distal smallbowel and colon related to Crohn’s disease and previous surgical anastomoses. 105 Pediatric endoscopic dilation can be performed by through-the- endoscope

2014 American Society for Gastrointestinal Endoscopy

9. Dysphagia

, acyclovir) None Peptic stricture Antisecretory drugs (proton- pump inhibitors), soft food Dilation Pharyngoesophageal (Zenker) diverticulum None Endoscopic myotomy or cricopharyngeal myotomy with diverticulectomy Schatzki ring Soft food Dilation Scleroderma Antisecretory drugs, systemic medical management of scleroderma None POEM, peroral endoscopic myotomy. Peptic esophageal strictures Peptic strictures are usually the result of gastroesophageal reflux disease (GERD), but strictures can also be caused (...) be indicated in patients with benign strictures [41]. The risk of perforation is about 0.5% and there is a high rate of stent migration in these conditions. ? Surgery is generally indicated if frank perforation occurs, but endoscopic methods of wound closure are being developed. Treatment of lower esophageal mucosal rings (including Schatzki ring) ? Dilation therapy for lower esophageal mucosal rings involves the passage of a single large bougie (45–60 Fr) or balloon dilation (18–20 mm) aimed at fracturing

2014 World Gastroenterology Organisation

10. Diagnosis and Management of Gastroesophageal Reflux Disease

level of evidence) 4. Injection of intralesional corticosteroids can be used in refractory, complex strictures due to GERD. (Conditional recommendation, low level of evidence) 5. Treatment with a PPI is suggested following dilation in patients with lower esophageal (Schatzki) rings. (Conditional recommendation, low level of evidence) 6. Screening for Barrett’s esophagus should be considered in patients with GERD who are at high risk based on epidemiologic pro? le. (Conditional recommendation

2013 American College of Gastroenterology