Esophageal Webs: Diagnosis, Symptoms, and Treatment Strategies w/ Dr. Ashley Walther
With Dr. Ashley Walther · hosted by Dr. Jill Knebrock
Chapter 1 of 4 · Fundamentals
Introduction
Introduction and Speaker Identification
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
More from this expert
Dr. Ashley WaltherWhat the experts said
Esophageal webs are eccentric thin (less than 2 millimeter) congenital membranous structures in the lumen of the esophagus.
The most common region for esophageal webs is proximal, but they can occur more distally.
Esophageal webs can be associated with Plummer-Vinson syndrome, which includes the web, iron deficiency anemia, and glossitis.
The treatment of Plummer-Vinson syndrome includes iron supplements.
Unlike strictures, esophageal webs show a one-sided web appearance (a shelf), which is very classic.
Endoscopic interventions can be performed before proceeding to surgery for esophageal webs.
The standard of care for esophageal webs is endoscopic mechanical disruption with dilation: bougies if they're thin and proximal, balloons if they're tight, tortuous, or long.
Esophageal webs are often asymptomatic.
When symptoms occur with esophageal webs, they show up as dysphagia and regurgitation in infants when they transition to solid foods.
Plummer-Vinson syndrome is a rare disorder.
Symptoms of Plummer-Vinson syndrome include fatigue, a sore tongue, and spoon-shaped nails.
Treatment of Plummer-Vinson syndrome may involve esophageal dilation to widen the esophagus.
Esophageal dilation in Plummer-Vinson syndrome can improve symptoms and reduces the risk of squamous cell carcinoma associated with the syndrome.
Workup for esophageal webs includes upper endoscopy, which shows a shelf-like appearance and dilation proximal to the esophageal web.
Endoscopic interventions for esophageal webs include laser, steroid injections, and temporary stents.
Surgery should be considered if the patient is having symptoms with an isolated congenital esophageal web, or if they have significant obstruction from Plummer-Vinson syndrome.
Esophageal webs may be linked to Plummer-Vinson syndrome, which has an increased risk of squamous cell carcinoma.
First line treatment for esophageal webs is endoscopic mechanical dilation with surgery reserved for severe or refractory cases.