Name
PLUMMER-VINSON SYNDROME
DESCRIPTION
DETAIL
D.D. : - ESOPHAGEAL CANCER - ESOPHAGEAL WEB & RINGS - HYPOPHARYNGEAL CANCER - IRON DEFICIENCY ANEMIA - HETEROTOPIC GASTRIC MUCOSA WITH STRICTUREOTHER TESTS : * IRON DEFICIENCY ANEMIA * BARIUM SWALLOW SHOW WEB LIKE CONSTRICTION OF THE ESOPHAGUS. * VIDEOFLUOROSCOPY - MOST ENSITIVE & TEST OF CHOICE
TYPENOTES
Medical Care: " Treat iron deficiency and its underlying cause. o Iron replacement is necessary to correct the anemia, if present, and to resolve most of the physical signs of iron deficiency. The necessity for continued iron treatment is doubtful other than for anemia correction. o Dysphagia may improve with iron replacement alone, particularly in patients whose webs are not substantially obstructive. Dysphagia caused by more advanced webs is unlikely to respond to iron replacement alone, and thus is managed with mechanical dilation. o Address the cause of the iron deficiency (eg, celiac sprue, bleeding angiectasias). " Treat dysphagia and web. o Aside from iron replacement, diet modification may be sufficient in mildly symptomatic patients. Those with significant and long-standing dysphagia usually require mechanical dilation. The web can often be disrupted during simple passage of the endoscope into the esophagus. Otherwise, passage of a bougie (eg, Savary dilator) is quite effective. In most cases, passage of a single large dilator is adequate and is thought to be more effective than serial progressive dilations. Fluoroscopic guidance is usually not required unless a tight web precludes further passage of the endoscope. The proximal location of the webs in PVS makes endoscopic balloon dilation difficult, but it has been performed successfully by radiology under fluoroscopic guidance. o ND:YAG laser therapy has also been reported as a successful means of disrupting an esophageal web. This modality is rarely required. Surgical Care: " Surgery is rarely needed and is reserved for patients whose webs are recalcitrant to dilation or associated with Zenker diverticulum. Diet: " Advise patients to eat slowly and chew thoroughly. Solid foods should be prepared and cut in small pieces, especially meats. Activity: Unrestricted DRUG TREATMENT : 1. IRON PREPARATIONS
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
SERUM IRON ( MALE ), X-RAY BARIUM SWALLOW, SERUM FERRITIN ( FEMALE ), COMPLETE BLOOD COUNT