Esophageal Rings and Stricture Related to a Circumferential Inlet Patch

Inlet patches are sometimes seen during upper endoscopy, usually in the proximal esophagus. Complications of inlet patches can cause a wide array of symptoms and complications. A man presented with dysphagia and was found to have 2 rings in the upper esophagus, just above and below a circumferential inlet patch. The more distal ring caused a stenosis, which produced the symptoms. Savary dilation and treatment with a proton pump inhibitor led to symptom resolution. Pathology was missed on the patient's first endoscopy, highlighting the importance of looking for pathology throughout the entire esophagus, not just in the distal esophagus.