Plummer–Vinson syndrome successfully treated by endoscopic dilatation
Article first published online: 19 NOV 2007
Journal of Gastroenterology and Hepatology
Volume 22, Issue 12, pages 2348–2351, December 2007
How to Cite
Enomoto, M., Kohmoto, M., Arafa, U. A., Shiba, M., Watanabe, T., Tominaga, K., Fujiwara, Y., Saeki, Y., Higuchi, K., Nishiguchi, S., Shiomi, S., Osugi, H., Kinoshita, H. and Arakawa, T. (2007), Plummer–Vinson syndrome successfully treated by endoscopic dilatation. Journal of Gastroenterology and Hepatology, 22: 2348–2351. doi: 10.1111/j.1440-1746.2006.03430.x
- Issue published online: 19 NOV 2007
- Article first published online: 19 NOV 2007
- Accepted for publication 31 October 2003.
- endoscopic bougienage;
- esophageal webs;
- Paterson–Brown–Kelly syndrome;
- Plummer–Vinson syndrome
Plummer–Vinson (Paterson–Brown–Kelly) syndrome is uncommon nowadays. Although iron repletion improves its symptoms, endoscopic dilatation of associated esophageal webs is sometimes required. The case is described of a 69-year-old woman with Plummer–Vinson syndrome who was successfully treated by endoscopic bougienage. The patient had a longstanding history of anemia and slowly progressive dysphagia of solid food. Laboratory data on admission showed iron deficiency anemia (red blood cell count 402 × 104/µL, hemoglobin 6.8 g/dL, serum iron 8 µg/dL, and serum ferritin 2.4 ng/mL). Radiographic esophagography revealed two circumferential webs at the level of the cervical esophagus. Upper gastrointestinal endoscopy showed a severe upper esophageal stricture caused by a smooth mucosal diaphragm. The patient was prescribed 40 mg of intravenous iron supplements daily for 30 days; her anemia improved but the dysphagia did not. Endoscopic bougienage was performed with the use of Celestin dilators of serially increasing diameters. The webs were easily disrupted without complications. The patient’s dysphagia resolved shortly after the treatment and did not recur. This experience indicates that endoscopic bougienage is safe, effective, and relatively easy to perform in patients with severe esophageal stenosis.