What endoscopic findings characterize a Schatzki ring?

• A. A thin mucosal ring at the distal esophagus near the gastroesophageal junction causing intermittent solid-food dysphagia
• B. Ulcerated lesion in the distal esophagus
• C. A submucosal mass at the gastroesophageal junction
• D. A diverticulum in the cervical esophagus

Answer: (A)

Schatzki ring is a thin circumferential mucosal ring in the distal esophagus just above the gastroesophageal junction. On endoscopy you’d see a smooth, constricting ring that narrows the lumen, with the surrounding mucosa typically normal. This location and mucosal nature explain the symptom pattern of intermittent solid-food dysphagia, especially with larger bites or meats, while liquids pass more easily. Other described findings—an ulcerated distal esophageal lesion, a submucosal mass at the GE junction, or a cervical esophageal diverticulum—do not present as a thin mucosal ring at the distal esophagus and thus are not Schatzki rings.