title: Plummer-Vinson syndrome successfully treated by endoscopic dilatation.
abstract: 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 x 10(4)/microL, hemoglobin 6.8 g/dL, serum iron 8 microg/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.
authors.affiliation: Third Department of Internal Medicine, Osaka City University Medical School, Abeno-ku, Osaka, Japan. enomoto-m@med.osaka-cu.ac.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Enomoto
authors.forename: Madoka
authors.initials: M
authors.lastname: Kohmoto
authors.forename: Usama Ahmed
authors.initials: UA
authors.lastname: Arafa
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Shiba
authors.forename: Toshio
authors.initials: T
authors.lastname: Watanabe
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tominaga
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saeki
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Shiomi
authors.forename: Haruji
authors.initials: H
authors.lastname: Osugi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
mesh_terms: D000368:Aged; D004106:Dilatation / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D011004:Plummer-Vinson Syndrome / Q000628:therapy*