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Esophageal web - Wikipedia

From Wikipedia, the free encyclopedia

Esophageal web

Specialty	Gastroenterology

Esophageal webs are thin membranes occurring anywhere along the esophagus.^[1]

Presentation

Its main symptoms are pain and difficulty in swallowing (dysphagia).^[2]

Esophageal webs are thin 2–3 mm (0.08–0.12 in) membranes of normal esophageal tissue consisting of mucosa and submucosa that can partially protrude/obstruct the esophagus. They can be congenital or acquired. Congenital webs commonly appear in the middle and inferior third of the esophagus, and they are more likely to be circumferential with a central or eccentric orifice. Acquired webs are much more common than congenital webs and typically appear in the cervical area (postcricoid).^{[citation needed]}

Clinical symptoms of this condition are selective (solid more than liquids) dysphagia, thoracic pain, nasopharyngeal reflux, aspiration, perforation and food impaction (the last two are very rare).^{[citation needed]}

Esophageal web stenosis in barium swallow examination lateral view.
Web with "jet-phenomenon". Arrowhead on incomplete opening of the upper esophageal sphincter.
Esophageal web stenosis in barium swallow examination frontal view.

Causes

They are mainly observed in the Plummer–Vinson syndrome,^[3] which is associated with chronic iron deficiency anemia. One in 10 patients with Plummer-Vinson syndrome will eventually develop squamous cell carcinoma of the esophagus,^[4] but it is unclear if esophageal webs in and of themselves are a risk factor.

Esophageal webs are associated with bullous diseases (such as epidermolysis bullosa, pemphigus, and bullous pemphigoid), with graft versus host disease involving the esophagus, and with celiac disease.^[5]

Esophageal webs are more common in white individuals and in women (with a ratio of 2:1). The literature describes relations between these webs and Plummer-Vinson Syndrome, bullous dermatologic disorders, inlet patch, graft-versus-host disease and celiac disease. The postulated mechanisms are sideropenic anemia (mechanism unknown) or some interference of the immune system. Esophageal webs can be ruptured during upper endoscopy.^{[citation needed]}

Diagnosis

The diagnostic test of choice is a barium swallow.^{[citation needed]}

Treatment

Esophageal webs and rings can be treated with endoscopic dilation.^{[citation needed]}

References

^ Medscape "Esophageal Webs and Rings" Retrieved on 27 March 2017
^ "Dysphagia". The Lecturio Medical Concept Library. Retrieved 10 August 2021.
^ Okamura H, Tsutsumi S, Inaki S, Mori T (September 1988). "Esophageal web in Plummer-Vinson syndrome". The Laryngoscope. 98 (9): 994–8. doi:10.1288/00005537-198809000-00014. PMID 3412097.
^ "What are the risk factors for cancer of the esophagus?". Esophagus Cancer. American Cancer Society. Archived from the original on 25 July 2010. Retrieved 15 April 2012.
^ Fasano A (April 2005). "Clinical presentation of celiac disease in the pediatric population". Gastroenterology (Review). 128 (4 Suppl 1): S68–73. doi:10.1053/j.gastro.2005.02.015. PMID 15825129.

External links

Congenital malformations and deformations of digestive system

Upper GI tract

Tongue, mouth and pharynx	Cleft lip and palate Van der Woude syndrome tongue Ankyloglossia Macroglossia Hypoglossia
Esophagus	EA/TEF Esophageal atresia: types A, B, C, and D Tracheoesophageal fistula: types B, C, D and E Esophageal inlet patch esophageal rings Esophageal web (upper) Schatzki ring (lower)
Stomach	Pyloric stenosis Hiatus hernia

Lower GI tract

Intestines	Intestinal atresia Duodenal atresia Meckel's diverticulum Hirschsprung's disease Intestinal malrotation Dolichocolon Enteric duplication cyst
Rectum/anal canal	Imperforate anus Rectovestibular fistula Persistent cloaca Rectal atresia

Accessory

Pancreas	Annular pancreas Accessory pancreas Johanson–Blizzard syndrome Pancreas divisum
Bile duct	Choledochal cysts Caroli disease Biliary atresia
Liver	Alagille syndrome Polycystic liver disease

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Classification	D ICD-10: Q39.4 DiseasesDB: 31503
External resources	eMedicine: med/3413