Rings and Webs

Rings and Webs

Pathogenesis. Schatzki’s ring and Plummer-Vinson syndrome reveal thin, epithelial membranes made out of squamous epithelial cells. Neither of them is progressive in nature, distinguishing both of these conditions from achalasia.

Schatzki’s ring is more common and leads to intermittent dysphagia and is not associated with pain. It is also more distal and located at the squamocolumnar junction proximal to the lower esophageal sphincter.

Plummer-Vinson syndrome (PVS) is more proximal and is located in the hypopharynx. The dysphagia is sometimes with liquids as well. Plummer-Vinson syndrome is associated with iron- deficiency anemia and squamous cell cancer; it most often occurs in middle-aged women.

Diagnosis. Both disorders are best diagnosed with a barium swallow or barium esophagram.

Treatment. Plummer-Vinson syndrome may respond to treatment of the iron deficiency. Both are treated with dilation procedures.