Background and Aims
Schatzki rings are found in the distal esophagus, are associated with hiatal hernias,
and present with intermittent dysphagia to solid foods. They can be identified by
radiology (GI series or barium swallow studies) or endoscopy. Rings are not always
visualized during endoscopy in patients in whom they are suspected clinically. The
Bolster technique involves application of epigastric abdominal pressure, which offers
the potential to reveal a Schatzki ring that is otherwise obscured within a reduced
hiatal hernia. The aim of this study was to determine whether the Bolster technique
improves endoscopic detection of Schatzki rings.
Methods
We reviewed 30 symptomatic patients with a history of a Schatzki ring in a tertiary
care center. The Bolster technique was applied to patients in whom the ring was not
visible during standard endoscopy. The main outcome measurement was identification
of the Schatzki ring after the Bolster technique.
Results
A Schatzki ring was visible during standard endoscopy in 26 of the 30 patients. In
the remaining 4, the ring was visible only after the application of the Bolster technique.
Conclusion
The Bolster technique is a simple maneuver that can increase detection rates of Schatzki
rings during endoscopy.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Gastrointestinal EndoscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Schatzki ring in pediatric and young adult populations.Pediatr Radiol. 2012; 42: 1437-1440
- Lower esophageal ring.N Engl J Med. 1970; 282: 1298-1305
- Is the Schatzki ring a unique esophageal entity?.World J Gastroenterol. 2011; 17: 2838-2843
- The lower esophageal ring: long term follow-up of symptomatic and asymptomatic rings.AJR Am J Roentgenol Radium Ther Nucl Med. 1963; 90: 805
- Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: evaluation of individual techniques.Gastrointest Radiol. 1985; 10: 311-316
- Radiologic detection and spectrum of appearances of peptic esophageal strictures.J Clin Gastroenterol. 1982; 4: 11-15
- Lower esophageal mucosal ring: correlation of referred symptoms with radiographic findings using a marshmallow bolus.AJR Am J Roentgenol. 1998; 171: 1361-1365
- Obliteration of symptomatic Schatzki rings with jumbo biopsy forceps (with video).Dis Esophagus. 2014; 27: 607-610
- Endoscopic findings in patients presenting with dysphagia: analysis of a national endoscopy database.Dysphagia. 2012; 27: 101-105
- Analysis of thirty-two patients with Schatzki’s ring.Am J Surg. 1989; 158: 563-566
- Schatzki’s ring: a benign cause of dysphagia in adults.J Clin Gastroenterol. 2002; 35: 295-298
Article Info
Publication History
Published online: November 05, 2015
Accepted:
October 25,
2015
Received:
August 14,
2015
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Yet another provocative maneuver to accentuate Schatzki ringsGastrointestinal EndoscopyVol. 84Issue 4
- PreviewI read the New Methods article by Dr Jouhourian and colleagues1 with great interest.1 In brief, the authors describe a novel maneuver (Bolster technique) that may be used to accentuate and diagnose what may be a suspected but “hidden” Schatzki ring. The authors’ report also reviewed other techniques that have been used by radiologists. I have yet another option. Over 25 years ago, I had the privilege of training under Dr Donald O. Castell. When a suspected Schatzki ring was not visualized during upper GI endoscopy, Dr Castell suggested that we simply have the patient deeply inspire while the endoscope was positioned in the distal esophagus.
- Full-Text
- Preview
