Esophageal webs and rings

 Esophageal webs and rings


Esophageal webs and rings are outpouchings or growths which may partially occlude the lumen. The clinical presentation varies from being asymptomatic to having intermittent dysphagia to solids.

Webs are predominantly seen in the proximal esophagus (near throat) and rings in the distal esophagus (near stomach)



Risk factors

The etiology of esophageal webs and rings is poorly understood. However, it commonly seen with the following disorders: -

a)      Plummer-Vinson syndrome

b)      Zenker’s diverticulum

c)      Epidermolysis bullosa

d)      Hiatus hernia

e)      Eosinophilic esophagitis (rings)


Clinical features

Most esophageal webs and rings are seen incidentally on upper gastrointestinal endoscopy. However, a small percentage may present with

1.      Intermittent dysphagia to solids

2.      Impaction of food


Evaluation

1.      Upper gastrointestinal endoscopy is the best diagnostic test. It helps identify the cause of the dysphagia

2.      Complete blood count and iron studies to rule out Plummer Vinson Evaluation

1.      1. Upper gastrointestinal endoscopy is the best diagnostic test. It helps identify the cause of the dysphagia

2.    2.  Complete blood count and iron studies to rule out Plummer Vinson


Treatment

1.      Esophageal dilatation by upper GI endoscopy

2.      1. Proton pump inhibitors

3.     2.In refractory cases, incisional therapy

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