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April 1960

The Lower Esophageal Ring

Author Affiliations

U.S. Army
Capt. Helmus is now Resident in Otolaryngology, Veterans Administration Hospital, Dallas, Texas.

AMA Arch Otolaryngol. 1960;71(4):614-618. doi:10.1001/archotol.1960.03770040014002

In 1953, Ingelfinger and Kramer, and later Schatzki and Gary, described a ringlike narrowing of the lower esophagus which produced dysphagia.1,2 Since then, several other similar cases have been described. Here is another case report of this peculiar entity.

Report of a Case  A 43-year-old master sergeant was admitted to the U.S. Army Hospital, Fort Leonard Wood, Mo., on Dec. 11, 1958. For six months prior to admission he complained of intermittent, sudden, substernal pain while eating solids. The dysphagia varied from a dull ache to a sharp lancinating pain. It never lasted more than a few minutes. The patient felt relief immediately when the bolus seemed to pass an obstructed area. He would regurgitate voluntarily if the bolus did not pass promptly. (He learned to regurgitate voluntarily after years of alcoholism.) Hard boiled eggs, roast beef, bread, and most other dry foods would produce his dysphagia. There was