Scharschmidt B F, Watts H D
Am J Gastroenterol. 1978 May;69(5):544-9.
Although the lower esophageal ring is an important cause of dysphagia in adults, its pathogenesis is unknown. To better define the relationship between the lower esophageal ring and esophageal reflux, we analyzed, retrospectively, the records of 18 hospitalized patients with radiologically demonstrated rings (16 confirmed by endoscopy and/or surgery). In 16 of these patients, evidence of esophageal reflux including at least one of the following was present: overt esophagitis noted at endoscopy or surgery (14 cases), histologic evidence of esophagitis (3 cases), and/or symptoms of pyrosis or free reflux (13 cases). These findings suggest that 1. reflux is frequently associated with lower esophageal rings and may play a role in their pathogenesis; 2. the radiologic finding of a ring should serve as a clue to the possibility of esophageal reflux and 3. long-term control of dysphagia in these patients may depend upon control of the associated reflux as well as mechanical disruption of the ring.
尽管下食管环是成人吞咽困难的一个重要原因，但其发病机制尚不清楚。为了更好地界定下食管环与食管反流之间的关系，我们回顾性分析了18例经放射学证实有下食管环的住院患者的记录（其中16例经内镜检查和/或手术确诊）。在这些患者中的16例中，存在食管反流的证据，包括以下至少一项：内镜检查或手术时发现的明显食管炎（14例）、食管炎的组织学证据（3例）和/或烧心或自由反流症状（13例）。这些发现提示：1. 反流常与下食管环相关，可能在其发病机制中起作用；2. 下食管环的放射学表现应作为食管反流可能性的线索；3. 这些患者吞咽困难的长期控制可能取决于相关反流的控制以及下食管环的机械性破坏。
