Esophageal web

Last revised by Mohammad Taghi Niknejad on 30 Apr 2024

Esophageal webs refer to an esophageal constriction caused by a thin mucosal membrane projecting into the lumen.

Esophageal webs tend to affect middle-aged females.

Patients are usually asymptomatic and the finding may be incidental and unimportant. However, if the stenosis is severe symptoms include dysphagia and regurgitation of food.

More commonly occur in the cervical esophagus near cricopharyngeus muscle than in the thoracic esophagus. They typically arise from the anterior wall and never from the posterior wall; they can also be circumferential 4. Occasionally, multiple webs are visualized during maximal distension. 

  • may be demonstrated on high-volume barium oesophagrams when the esophagus is fully distended 4

  • a "jet effect" of contrast passing distal to the web may be seen 6

An esophageal web may indicate an esophagus at higher risk of upper esophageal and hypopharyngeal carcinoma.

Treatment options include:

  • balloon dilatation

  • bougienage (dilatation with a bougie) during endoscopy 8

  • submucosal venous plexus: normal structure, noted anteriorly only as slightly irregular mucosa 5

  • Schatzki ring: occurs in the distal esophagus

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