Esophageal web

Template:Short description Template:Use dmy dates Template:Infobox medical condition (new) Esophageal webs are thin membranes occurring anywhere along the esophagus.<ref>Medscape "Esophageal Webs and Rings" Retrieved on 27 March 2017</ref>

Presentation

Its main symptoms are pain and difficulty in swallowing (dysphagia).<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Esophageal webs are thin Template:Convert 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).Template: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).Template:Citation needed

• Zervikales Web.jpg

  Esophageal web stenosis in barium swallow examination lateral view.

• Web mit Jet-Phaenomen.jpg

  Web with "jet-phenomenon". Arrowhead on incomplete opening of the upper esophageal sphincter.

• Zervikales Web pa.jpg

  Esophageal web stenosis in barium swallow examination frontal view.

Causes

They are mainly observed in the Plummer–Vinson syndrome,<ref name="pmid3412097">Template:Cite journal</ref> 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,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> 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.<ref>Template:Cite journal</ref>

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.Template:Citation needed

Diagnosis

The diagnostic test of choice is a barium swallow.Template:Citation needed

Treatment

Esophageal webs and rings can be treated with endoscopic dilation.Template:Citation needed