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 the throat) and ring in the distal esophagus (near the stomach).



Risk factors

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

  • Plummer-Vinson syndrome
  • Zenker’s diverticulum
  • Epidermolysis bullosa
  • Hiatus hernia
  • 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

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

Complete blood count and iron studies to rule out Plummer Vinson

Treatment

  • Esophageal dilatation by upper GI endoscopy
  • Proton pump inhibitors
  • In refractory cases, incisional therapy


Comments

Post a Comment

Popular posts from this blog

Advanced Endoscopy procedures

Image
What Are Advanced Endoscopy Procedures? Advanced endoscopy ” is a term used to describe therapeutic procedures in which endoscopy is a primary tool, including endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), stent placements, and endoscopic resections, among others. “ Advanced Endoscopy procedures
Read more

What is Gastric Polyps?

Image
Gastric Polyps  Gastric polyps are masses or a small aggregation of cells seen in the stomach. They represent areas of higher-than-normal proliferative growth and may potentially turn neoplastic.    They can be further sub-divided into  1) Gastric hyperplastic polyps  2) Fundic gastric polyp  3) Adenomatous polyp s Most polyps are diagnosed incidentally on upper GI endoscopy. Gastric hyperplastic polyps are associated with chronic H.pylori infection and atrophic gastritis.  Risks associated with gastric polyps    1. Age     2. Chronic H.pylori infection    3. Chronic gastritis due to any cause    4. Genetically inherited polyposis syndromes like Familial adenomatous polyposis (FAP) Clinical features  Majority of the polyps are asymptomatic and are incidentally found. However, a     fraction of cases may present with    1. Heartburn and chest discomfort    2. Indigestio...
Read more

Endoscopic submucosal dissection

Image
Endoscopic Submucosal Dissection  Endoscopic submucosal dissection (ESD) is a procedure to remove tumors from the gastrointestinal (GI) tract. It is done under general anesthesia and is done mostly on outpatient basis.  It is done using a high-definition upper GI endoscope either through the mouth or anus (depending on location of the tumor). An electrosurgical knife used to cut the tumor from the adjacent tissue with the use of high-frequency electrical current.  The knife also aids in cauterizing any bleed during the procedure. The tissue which is excised is then sent for histopathological examination. It is indicated in: -  1. Early-stage cancer of the GI tract (especially esophagus)  2. Polyps  3. Non-invasive tumors of the stomach or large intestine  4. Pre-malignant diseases like Barrett’s Special note: -  a) Because it is special minimally invasive procedure, the organ of involvement is preserved. This helps maintain quality of life fo...
Read more