Esophageal web

Changed by Amir Rezaee, 6 Jun 2015

Updates to Article Attributes

Body was changed:

Oesophageal webs refer to a ring-like oesophagealan oesophageal constriction caused by a thin mucosal membrane projecting into the lumen.

Epidemiology

Oesophageal webs tend to affect middle-aged females.

Clinical presentation

Patients are usually asymptomatic and the finding may be incidental and unimportant. However, if the stenosis is severe symptoms include dysphagia and regurgitation of food.

Pathology

Location

More commonly occur in the cervical oesophagus near cricopharyngeus muscle than in the thoracic oesophagus. They typically arise from the anterior wall and never from the posterior wall; they can also be circumferential 4. Occasionally, multiple webs are visualised during maximal distension. 

Associations

Radiographic appearance

Fluoroscopy: barium swallow
  • may be demonstrated on high-volume barium oesophagrams when the oesophagus is fully distended 4
  • a "jet effect" of contrast passing distal to the web may be seen 5

Treatment and prognosis

Treatment options include:

  • balloon dilatation
  • bougienage during endoscopy

There is a high risk of upper oesophageal and hypopharyngeal carcinoma.

Differential diagnosis

  • submucosal venous plexus: normal structure, noted anteriorly only as slightly irregular mucosa 5
  • Schatzki ring: occurs in the distal oesophagus
  • -<p><strong>Oesophageal webs</strong> refer to a ring-like oesophageal constriction caused by a thin mucosal membrane projecting into the lumen.</p><h4>Epidemiology</h4><p>Oesophageal webs tend to affect middle-aged females.</p><h4>Clinical presentation</h4><p>Patients are usually asymptomatic and the finding may be incidental and unimportant. However, if the stenosis is severe symptoms include dysphagia and regurgitation of food.</p><h4>Pathology</h4><h5>Location</h5><p>More commonly occur in the cervical <a href="/articles/oesophagus">oesophagus</a> near cricopharyngeus muscle than in the thoracic oesophagus. They typically arise from the anterior wall and never from the posterior wall; they can also be circumferential <sup>4</sup>. Occasionally, multiple webs are visualised during maximal distension. </p><h5>Associations</h5><ul><li><a href="/articles/plummer-vinson-syndrome">Plummer-Vinson syndrome</a></li></ul><h4>Radiographic appearance</h4><h5>Fluoroscopy: barium swallow</h5><ul>
  • +<p><strong>Oesophageal webs</strong> refer to an oesophageal constriction caused by a thin mucosal membrane projecting into the lumen.</p><h4>Epidemiology</h4><p>Oesophageal webs tend to affect middle-aged females.</p><h4>Clinical presentation</h4><p>Patients are usually asymptomatic and the finding may be incidental and unimportant. However, if the stenosis is severe symptoms include dysphagia and regurgitation of food.</p><h4>Pathology</h4><h5>Location</h5><p>More commonly occur in the cervical <a href="/articles/oesophagus">oesophagus</a> near cricopharyngeus muscle than in the thoracic oesophagus. They typically arise from the anterior wall and never from the posterior wall; they can also be circumferential <sup>4</sup>. Occasionally, multiple webs are visualised during maximal distension. </p><h5>Associations</h5><ul>
  • +<li><a href="/articles/plummer-vinson-syndrome">Plummer-Vinson syndrome</a></li>
  • +<li><a title="GvHD" href="/articles/graft-versus-host-disease">GVHD</a></li>
  • +<li><a title="GORD" href="/articles/gastro-oesophageal-reflux-disease">GORD</a></li>
  • +</ul><h4>Radiographic appearance</h4><h5>Fluoroscopy: barium swallow</h5><ul>

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