PTH-68 Schatzki rings are commonly misdiagnosed in patients with eosinophilic oesophagitis

IntroductionEosinophilic oesophagitis (EoE) is an increasingly common disorder characterised by the accumulation of eosinophils within the oesophageal epithelium. Schatzki rings are defined as thin mucosal fibrotic rings most commonly seen at the GOJ. Schatzki rings can be mistaken for fibrotic strictures of EoE and it is therefore important to biopsy all rings and strictures to ascertain whether eosinophils are present. The aim of the current study was to assess what proportion of patients undergoing diagnostic gastroscopy where a Schatzki ring is identified, in fact have EoE when biopsied.MethodsAll endoscopic and pathology text extraction was performed using EndoMineR. All free text endoscopy reports containing the term ‘Schatzki’ and any spelling variants were identified between 1st Jan 2007 and 23rd January 2021. Typical EoE endoscopic findings were extracted (Table 1). The histopathology free text from any oesophageal biopsies from the same cohort was analysed and results showing the presence of >15 eosinophils per high power field were identified as diagnostic of EoE.In addition the endoscopies from all patients with EoE diagnosed at any point using for the same time period on biopsy from the oesophagus were obtained from the pathology database and manually validated. EoE patients with strictures or rings were identified as being fibrostenotic (EoE-FS) To determine whether patients with EoE and Schatzki rings (EoE-Schatzki) were likely to be the same phenotype as EoE-FS at endoscopy were then compared to those the EoE and no Schatzki rings for all the variables detailed aboveResultsAbstract PTH-68 Table 1Comparison of findings of fibrostenotic versus Schatzki EoECharacteristic EoE-FS, N = 67 EoE-Schatzki, N = 35 p-value2 Sex 0.5 F 14 (21%) 10 (29%) M 53 (79%) 25 (71%) Age at diagnosis (yrs) 41 (14) 51 (16) 0.005 Atopic history 26 (39%) 9 (26%) 0.2 Hiatus Hernia 10 (15%) 20 (57%)