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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.
- Plummer-Vinson syndrome
- graft-versus-host disease
- gastroesophageal reflux disease (especially a distal esophagus web) 7
- external beam radiation
Fluoroscopy: barium swallow
- 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
Treatment and prognosis
Treatment options include:
- balloon dilatation
- bougienage during endoscopy
- submucosal venous plexus: normal structure, noted anteriorly only as slightly irregular mucosa 5
- Schatzki ring: occurs in the distal esophagus
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- 3. Kim KH, Kim MC, Jung GJ. Gastric cancer occurring in a patient with Plummer-Vinson syndrome: a case report. World J. Gastroenterol. 2005;11 (44): 7048-50. World J. Gastroenterol. (link) - Pubmed citation
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- 5. Berry. Diagnostic Radiology. Jaypee Brothers Medical Publishers (P) Ltd. ISBN:8180612287. Read it at Google Books - Find it at Amazon
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- 7. Levine MS, Goldstein HM. Fixed transverse folds in the esophagus: a sign of reflux esophagitis. AJR Am J Roentgenol. 1984;143 (2): 275-8. doi:10.2214/ajr.143.2.275 - Pubmed citation