Esophageal Webs & Rings

Esophageal webs are thin, diaphragm-like membranes of squamous mucosa typically in the mid or upper esophagus and may be multiple

• May be congenital; also occur with eosinophilic esophagitis, graft-versus-host disease, pemphigoid, epidermolysis bullosa, pemphigus vulgaris

• Web plus iron deficiency anemia is known as Plummer-Vinson syndrome

Esophageal rings are smooth, circumferential, thin (< 4 mm) mucosal structures in the distal esophagus at the squamocolumnar junction

• Commonly associated with hiatal hernia

• May be related to gastroesophageal reflux disease

Solid-food dysphagia, characteristically intermittent and not progressive, with rings < 13 mm in diameter

Barium esophagogram with full esophageal distention

Endoscopy less sensitive for detection of subtle webs and rings

Passage of large bougie dilators to disrupt the web or ring

Long-term proton pump inhibitor therapy for patients who have heartburn or who require repeated dilation