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Digestive system diseases Hematologic diseases
Volume 187 - Issue 1

A web of dysphagia

Authors:  Sandeep Chauhan, Atul Sachdev, Sanjay D’Cruz, Ram Singh and Sandeep Singla

Med J Aust 2007; 187 (1): 51. || doi: 10.5694/j.1326-5377.2007.tb01119.x
Published online: 2 July 2007
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A 45-year-old woman presented with a 6-month history of dysphagia. Pallor and koilonychia were present on examination. Laboratory tests revealed microcytic hypochromic anaemia (haemoglobin, 59 g/L; mean cell volume, 65 fL), with decreased iron stores (on serum iron studies and bone marrow examination). Barium swallow (Figure A) and oesophagoscopy (Figure B) revealed an upper oesophageal web, which was fractured using Savary–Gilliard dilators. A diagnosis of Plummer–Vinson syndrome (oesophageal web, dysphagia and sideropenic anaemia) was made. As further investigations gave negative results (oesophagoduodenoscopy, colonoscopy, duodenal biopsy, measurement of anti-tissue transglutaminase antibodies, and stool examination for occult blood, ova and cysts), we attributed the iron deficiency to inadequate iron intake. This syndrome is associated with upper alimentary tract cancer, and surveillance endoscopy is recommended.

A: Barium swallow showing oesophageal web (arrow).

B: Oesophageal web seen on upper gastrointestinal endoscopy (arrows).

Authors

  • Sandeep Chauhan MD(Med)1
  • Atul Sachdev MD(Med), DM(Gastro)1
  • Sanjay D’Cruz MD(Med), DNB(Med), DM(Nephrol)1
  • Ram Singh MD(Med)1
  • Sandeep Singla MD(Med)2
  • 1. Department of Medicine, Government Medical College and Hospital, Chandigarh, India.
  • 2. Department of Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Correspondence: drsc88@rediffmail.com

View this article on Wiley Online Library

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