This patient has been referred for a dilatation
WHAT IS THE AETIOLOGY OF THE STRICTURE?
■ Peptic stricture
Too membrane-like to be peptic
■ Schatzki ring
Of course it is - Well Done!
■ Eosinophilic oesophagitis
Strictures in EoE are long and tapered
■ Radiotherapy stricture
RXT strictures are at least a couple of cm in length
■ Malignant stricture
Of course it isn't !
This short almost membrane-like stricture is of course a Schatzki ring, named after the German-American physician Dr Richard Schatzki. It's usually easy to treat these with a balloon dilatation. This particular case is unusual as two dilatations were required. However, rather than going ahead with a second dilatation to 20mm (our largest balloon in Leeds), I decided to cut the membrane with the tip of a snare and the diathermy set on the normal sphincterotomy setting.
The uploaded video is a good example of this mishap when cutting across yourself. I don't think that I perforated the full thickness of the oesophagus but applied a clip just in case (I've never regretted placing too many clips).