Plummer-Vinson syndrome (PVS) is a rare condition characterized by classical triad;high dysphagia, iron-deficiency anemia and oesophageal ring formation. We report a case of PVS in a 62-year-old patient admitted to th...Plummer-Vinson syndrome (PVS) is a rare condition characterized by classical triad;high dysphagia, iron-deficiency anemia and oesophageal ring formation. We report a case of PVS in a 62-year-old patient admitted to the department of gastroenterology and internal medicine for high dysphagia. The clinical examination showed anemic syndrome, general impairment and polyarthritis. Biological examinations concluded to iron deficiency anemia. The endoscopy had observed a circular ring immediately above Killian’s mouth ruptured during the examination. The patient was treated with iron and proton pump inhibitors. The oesophageal symptomatology regressed completely from the second day of treatment.展开更多
Congenital esophageal stenosis(CES) is an extremely rare malformation, and standard treatment have not been completely established. By years of clinical research, evidence has been accumulated. We conducted systematic...Congenital esophageal stenosis(CES) is an extremely rare malformation, and standard treatment have not been completely established. By years of clinical research, evidence has been accumulated. We conducted systematic review to assess outcomes of the treatment for CES, especially the role of endoscopic modalities. A total of 144 literatures were screened and reviewed. CES was categorized in fibromuscularthickening, tracheobronchial remnants(TBR) and membranous web, and the frequency was 54%, 30% and 16%, respectively. Therapeutic option includes surgery and dilatation, and surgery tends to be reserved for ineffective dilatation. An essential point is that dilatation for TBR type of CES has low success rate and high rate of perforation. TBR can be distinguished by using endoscopic ultrasonography(EUS). Overall success rate of dilatation for CES with or without case selection by using EUS was 90% and 29%, respectively. Overall rate of perforation with or without case selection was 7% and 24%, respectively. By case selection using EUS, high success rate with low rate of perforation could be achieved. In conclusion, endoscopic dilatation has been established as a primary therapy for CES except TBR type. Repetitive dilatation with gradual step-up might be one of safe ways to minimize the risk of perforation.展开更多
Plummer-Vinson syndrome （PVS）, also known as Paterson-Kelly syndrome or sideropenic dysphagia1 is characterized by dysphagia, iron deficiency anemia and esophageal webs. This syndrome is known to be associated with ...Plummer-Vinson syndrome （PVS）, also known as Paterson-Kelly syndrome or sideropenic dysphagia1 is characterized by dysphagia, iron deficiency anemia and esophageal webs. This syndrome is known to be associated with an increased risk of hypopharyngeal and/or cervical esophageal cancer. Three to 15 percent of the patients with PVS, mostly women between 15 and 50 years of age, have been reported to develop esophageal or pharyngeal cancer. There is a decreasing trend in the overall incidence of hypopharyngeal cancer in women, probably due to the diminished prevalence of PVS. There are few reports of gastric cancer in association with PVS.2展开更多
<strong>Introduction</strong><span style="font-family:;" "=""><strong>:</strong></span><b><span style="font-family:;" "=""...<strong>Introduction</strong><span style="font-family:;" "=""><strong>:</strong></span><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "="">Benign oesophageal strictures are defined as narrowing of the oesophageal lumen not related to neoplastic pathology. They are frequently encountered during endoscopic practice and are often responsible for a reduction in the qualit</span><span style="font-family:;" "="">y</span><span style="font-family:;" "=""> of life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little data are available on these benign esophageal strictures. The objective of our study was to determine the sociodemographic, diagnostic and therapeutic aspects of benign oesophageal strictures in a digestive endoscopy centre in Senegal. <b>Patients and Methods</b></span><b><span style="font-family:;" "="">: </span></b><span style="font-family:;" "="">This was a retrospective, descriptive study analysing reports of upper GI endoscopies performed between January 2015 and December 2017 in a hospital in Senegal. Reports that concluded to have non-neoplastic oesophageal stenosis were collated. Sociodemographic data, indications for and results of endoscopy, and therapeutic modalities wer</span><span style="font-family:;" "="">e</span><span style="font-family:;" "=""> collected. These data wer</span><span style="font-family:;" "="">e</span><span style="font-family:;" "=""> analysed using the Sphinx version 5 software.</span><span style="font-family:;" "=""> </span><b><span style="font-family:;" "="">Results</span></b><b><span style="font-family:;" "="">: </span></b><span style="font-family:;" "="">We collected 101 cases of benign oesophageal stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean age of the patients was 34 years (range 2 and 83 years) with a median of 37.9 years. There was a female predominance with a sex ratio of 0.38 <span>(73 females). Dysphagia, the main symptom, was present in 87 patients</span> (86</span><span style="font-family:;" "="">.</span><span style="font-family:;" "="">1% of cases) with a Dysphagia score greater than or equal to 2 in 51 patients (50.5%). The average duration of this dysphagia, excluding caustic stenosis, was 4 years (extremes 1 and 15 years). Endoscopy revealed simple stenosis in 76 cases (75.2% of cases). A membranous ring of the cervical oesophagus, suggestive of the Plummer-Vinson syndrome ring, was found in 60 patients (59.4% of cases) and was the primary cause;other aetiologies were dominated by caustic stenosis (19 cases), Schatzki rings (8 cases) and peptic stenosis (4 cases). Endoscopic dilatation was performed in 90 patients (89.1% of cases) with Savary Gilliard bougies (87 cases) and hydrostatic balloons (3 cases). The average number of dilatation sessions was 1.69. In 10 patients (11.1%), refractory stenosis was observed. This stenosis could be resolved after further dilatation in 8 cases before the 8th session. In 2 patients, dilatation failed.</span><span style="font-family:;" "=""> </span><b><span style="font-family:;" "="">Conclusion</span></b><b><span style="font-family:;" "="">: </span></b><span style="font-family:;" "="">Benign oesophageal strictures in our digestive endoscopy centre in Senegal mainly affect young adults, with a predominance of women. Diagnosis is often late. Cervical oesophageal rings in the context of Plummer-Vinson syndrome are the main cause. Oesophageal dilatation with bougies is of great therapeutic value.</span>展开更多
文摘Plummer-Vinson syndrome (PVS) is a rare condition characterized by classical triad;high dysphagia, iron-deficiency anemia and oesophageal ring formation. We report a case of PVS in a 62-year-old patient admitted to the department of gastroenterology and internal medicine for high dysphagia. The clinical examination showed anemic syndrome, general impairment and polyarthritis. Biological examinations concluded to iron deficiency anemia. The endoscopy had observed a circular ring immediately above Killian’s mouth ruptured during the examination. The patient was treated with iron and proton pump inhibitors. The oesophageal symptomatology regressed completely from the second day of treatment.
文摘Congenital esophageal stenosis(CES) is an extremely rare malformation, and standard treatment have not been completely established. By years of clinical research, evidence has been accumulated. We conducted systematic review to assess outcomes of the treatment for CES, especially the role of endoscopic modalities. A total of 144 literatures were screened and reviewed. CES was categorized in fibromuscularthickening, tracheobronchial remnants(TBR) and membranous web, and the frequency was 54%, 30% and 16%, respectively. Therapeutic option includes surgery and dilatation, and surgery tends to be reserved for ineffective dilatation. An essential point is that dilatation for TBR type of CES has low success rate and high rate of perforation. TBR can be distinguished by using endoscopic ultrasonography(EUS). Overall success rate of dilatation for CES with or without case selection by using EUS was 90% and 29%, respectively. Overall rate of perforation with or without case selection was 7% and 24%, respectively. By case selection using EUS, high success rate with low rate of perforation could be achieved. In conclusion, endoscopic dilatation has been established as a primary therapy for CES except TBR type. Repetitive dilatation with gradual step-up might be one of safe ways to minimize the risk of perforation.
文摘Plummer-Vinson syndrome （PVS）, also known as Paterson-Kelly syndrome or sideropenic dysphagia1 is characterized by dysphagia, iron deficiency anemia and esophageal webs. This syndrome is known to be associated with an increased risk of hypopharyngeal and/or cervical esophageal cancer. Three to 15 percent of the patients with PVS, mostly women between 15 and 50 years of age, have been reported to develop esophageal or pharyngeal cancer. There is a decreasing trend in the overall incidence of hypopharyngeal cancer in women, probably due to the diminished prevalence of PVS. There are few reports of gastric cancer in association with PVS.2
文摘<strong>Introduction</strong><span style="font-family:;" "=""><strong>:</strong></span><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "="">Benign oesophageal strictures are defined as narrowing of the oesophageal lumen not related to neoplastic pathology. They are frequently encountered during endoscopic practice and are often responsible for a reduction in the qualit</span><span style="font-family:;" "="">y</span><span style="font-family:;" "=""> of life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little data are available on these benign esophageal strictures. The objective of our study was to determine the sociodemographic, diagnostic and therapeutic aspects of benign oesophageal strictures in a digestive endoscopy centre in Senegal. <b>Patients and Methods</b></span><b><span style="font-family:;" "="">: </span></b><span style="font-family:;" "="">This was a retrospective, descriptive study analysing reports of upper GI endoscopies performed between January 2015 and December 2017 in a hospital in Senegal. Reports that concluded to have non-neoplastic oesophageal stenosis were collated. Sociodemographic data, indications for and results of endoscopy, and therapeutic modalities wer</span><span style="font-family:;" "="">e</span><span style="font-family:;" "=""> collected. These data wer</span><span style="font-family:;" "="">e</span><span style="font-family:;" "=""> analysed using the Sphinx version 5 software.</span><span style="font-family:;" "=""> </span><b><span style="font-family:;" "="">Results</span></b><b><span style="font-family:;" "="">: </span></b><span style="font-family:;" "="">We collected 101 cases of benign oesophageal stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean age of the patients was 34 years (range 2 and 83 years) with a median of 37.9 years. There was a female predominance with a sex ratio of 0.38 <span>(73 females). Dysphagia, the main symptom, was present in 87 patients</span> (86</span><span style="font-family:;" "="">.</span><span style="font-family:;" "="">1% of cases) with a Dysphagia score greater than or equal to 2 in 51 patients (50.5%). The average duration of this dysphagia, excluding caustic stenosis, was 4 years (extremes 1 and 15 years). Endoscopy revealed simple stenosis in 76 cases (75.2% of cases). A membranous ring of the cervical oesophagus, suggestive of the Plummer-Vinson syndrome ring, was found in 60 patients (59.4% of cases) and was the primary cause;other aetiologies were dominated by caustic stenosis (19 cases), Schatzki rings (8 cases) and peptic stenosis (4 cases). Endoscopic dilatation was performed in 90 patients (89.1% of cases) with Savary Gilliard bougies (87 cases) and hydrostatic balloons (3 cases). The average number of dilatation sessions was 1.69. In 10 patients (11.1%), refractory stenosis was observed. This stenosis could be resolved after further dilatation in 8 cases before the 8th session. In 2 patients, dilatation failed.</span><span style="font-family:;" "=""> </span><b><span style="font-family:;" "="">Conclusion</span></b><b><span style="font-family:;" "="">: </span></b><span style="font-family:;" "="">Benign oesophageal strictures in our digestive endoscopy centre in Senegal mainly affect young adults, with a predominance of women. Diagnosis is often late. Cervical oesophageal rings in the context of Plummer-Vinson syndrome are the main cause. Oesophageal dilatation with bougies is of great therapeutic value.</span>
