In adults, foreign body ingestion is mostly seen in specific high-risk groups of patients, including mentally impaired individuals, edentulous individuals, those with underlying esophageal pathology (i.e., esophageal ring
, stricture, and malignancy), those under the influence of alcohol, patients with psychiatric disorders, and prisoners seeking secondary gain by access to a medical facility [1, 3, 4].
By finger introduced into the mediastinum the pericardium is peeled from the diaphragm for 4-5cm ahead and in the width of the esophageal ring
. The ends of the yarn are carried out through the aperture of 2.5 cm from the front edge of the ring of the esophageal opening (Figure 1).
Those cases that get progressively worse could signal the failure of an esophageal ring
of muscle to relax (achalasia) or the deposit of connective tissue in the esophageal wall (scleroderma).
Analysis of the frequency of the endoscopic and histopathologic features of EoE showed similar rates among children and adults with the exception that esophageal ring
formation occurs significantly more in adults compared to children (75% versus 27%, P = 0.03) (Table 3).
Transnasal esophagoscopy (TNE) detected a lower esophageal ring
(Schatzki's ring) and a hiatal hemia (figure).
(25) In a series of 128 patients, the results of barium studies revealed that 18% had esophagitis, 14% had a lower esophageal ring
, and 3% had a peptic stricture.
Wallner, "Balloon dilation of benign esophageal rings
or strictures: a randomized clinical trial comparing two different inflation times," Diseases of the Esophagus, vol.
Three types of esophageal strictures are recognized: type 1: lesions involving the adventitia and tunica muscularis; type 2: esophageal rings
or webs that involve mucosa and submucosa; type 3: annular stenosis that involves all layers of the esophageal wall .
Endoscopically, adults with EoE were "substantially" more likely to have esophageal rings
, strictures, stenoses, linear furrows, crepe-paper mucosa, and white plaques or exudates, while patients with GERD were more likely to have hiatal hernias.
Multiple esophageal rings
: an association with eosinophilic esophagitis.
Of the cases of erosive esophagitis, 33 were grade A, and of those, 9 involved esophageal rings
(including 1 case of Barrett's esophagus), Dr.
These include weight lifting, laughing, hyperemesis gravidarum (severe, "morning sickness" during pregnancy), childbirth, seizures, hiccups, coughing and defecation. Predisposing factors may include hiatal hernia, peptic esophagitis, atrophic gastritis, motility disorders, lower esophageal rings
, food impaction and carcinoma. Reported incidences of Boerhaave syndrome have resulted from blunt trauma due to CPR or blows to the chest or abdomen.[4,9]