Intermittent dysphagia due to the presence of an annular constriction in the distal esophagus was reported for the first time in 1953. Ingelfinger and Kramer1 reported 6 cases of unknown nature and pathogenesis.
Schatzki and Gary2 presented some additional cases a few months later and recognized the presence of this idiopathic concentric narrowing in the distal esophagus as a separate clinical entity.
This contractile ring is usually located 3 to 5 cm. from the cardia and reduces markedly the lumen of the esophagus; in some instances the diameter of the esophageal lumen is reduced to only a few millimeters.
Endoscopic examination usually fails to reveal any inflammatory changes, scarring, ulceration, or tumor.
Barium-swallow studies and esophagograms demonstrate consistently the presence of the ring-like narrowing in the distal esophagus which represents a thin annular diaphragm producing partial obstruction of the esophagus.
This condition is usually an incidental finding on