Eastridge C E, Pate J W, Mann J A
Ann Thorac Surg. 1984 Feb;37(2):103-7. doi: 10.1016/s0003-4975(10)60294-9.
The lower esophageal ring is an unusual clinical disorder of the esophagus and consists of a thin submucosal circumferential scar that forms in the lower esophagus. It is probably an acquired lesion resulting from repeated insults to the lower esophageal mucosa. The symptom of dysphagia results from esophageal obstruction, and the degree of obstruction is directly related to the internal diameter of the ring. Episodic aphagia results from impaction of food at the site of the ring. Since 1970, 88 patients have been seen with either dysphagia or episodic aphagia. Sixty-five with chronic limited reflux were treated primarily by oral dilation. Two of them required an antireflux procedure at a later date because of accentuation of reflux symptoms. Eighteen patients received surgical treatment initially because of severe reflux disease. Treatment consisted of interruption of the ring combined with an antireflux procedure. Five patients received no treatment. Lower esophageal ring may be managed satisfactorily through oral dilation, resulting in relief of dysphagia. If reflux disease is present or is accentuated by dilation and cannot be controlled medically, then the appropriate antireflux procedure should be done.
下食管环是一种食管的罕见临床病症，由在下食管形成的薄的黏膜下环形瘢痕组成。它可能是由于下食管黏膜反复受损伤而形成的后天性病变。吞咽困难症状是由食管梗阻引起的，梗阻程度与环的内径直接相关。发作性吞咽不能是由于食物在环的部位嵌塞所致。自1970年以来，共诊治了88例有吞咽困难或发作性吞咽不能的患者。65例慢性局限性反流患者主要接受了口服扩张治疗。其中2例后来因反流症状加重而需要进行抗反流手术。18例患者最初因严重反流性疾病接受了手术治疗。治疗包括切断环并同时进行抗反流手术。5例患者未接受治疗。下食管环可通过口服扩张得到满意处理，从而缓解吞咽困难。如果存在反流性疾病或因扩张而加重且药物无法控制，则应进行适当的抗反流手术。
