Esophageal webs
Summary
Esophageal webs are thin (< 5 mm) membranes of mucosa and submucosa extending from the anterior esophageal wall, typically in the upper esophagus. Associated with Plummer-Vinson syndrome (iron deficiency, dysphagia, increased risk of esophageal squamous cell carcinoma) and anemia.
Detail
Esophageal webs are thin, partial-thickness strictures that do not completely occlude the esophageal lumen (unlike rings, which are full-thickness). They consist of mucosa and submucosa only. Webs typically present in the upper esophagus (C3-C4 level) and cause dysphagia to solids. Plummer-Vinson syndrome classically presents with the triad of iron deficiency anemia, dysphagia, and esophageal webs; there is a markedly elevated risk of esophageal squamous cell carcinoma (up to 10% lifetime risk). Diagnosis is by barium swallow showing a thin linear defect. Treatment is iron supplementation (may lead to web regression) and esophageal dilation for symptomatic patients. Other associations include celiac disease, pemphigus vulgaris, and caustic ingestion.
Sources
- First Aid for USMLE Step 1
- Harrison's Principles of Internal Medicine
- Robbins Pathology
Reviewed by AnkiBoss editorial — medical student review. Information here is for study reference only and is not medical advice. Spotted an error? Let us know.