Dysphagia due to multiple esophageal rings: DISCUSSION part1

In 1958 Shamma’a and Benedict reported 58 patients with esophageal webs, two of them having more than one web. These two patients were women with the Plummer-Vinson syndrome; one had two webs and the other had several webs, which were in the upper esophagus. Since then there have been a further 19 patients reported with two or more esophageal webs or rings (Tables 1,2).

TABLE 1 – Case reports of several esophageal webs/rings

Author/year 

(reference)

Sex Age 

(years)

Duration 

(years)

Location/ 

number*

Treatment 

t

Shamma’a/1958 (1) Female 44 10 Upper/two
Female 60 15 Upper/several t
Kelley/1966 (2) Male 46 20 Upper and mid/four Bougienage*
Longstreth/1979 (3) Male 21 14 Mid/two Bougienage*
Male 18 8 Mid/two Bougienage*
Male 40 15 Mid/two Bougienage*

*Number of webs/rings; Treatment consisted of esophagoscopywith divulsion of the web, repeated bougienage, iron therapy or a combination of these; ^Experienced an unusual degree of pain or bleeding

In 15 cases the rings/webs were multiple (Table 2). All cases but one were men, ranging from 13 to 84 years old, and all presented with a history of food impaction usually requiring endoscopic intervention. The webs/rings were in the mid- and distal esophagus or involved the entire esophagus.

TABLE 2  – Case reports of multiple esophageal webs/rings

Author/year 

(reference)

Sex Age 

(years)

Duration 

(years)

Location Treatment
Shiflett/1979 (4) Male 81 12 Entire Bougienage
Janisch/1982 (5) Male 42 5 Upper and mid Bougienage
Male 42 17 Upper and mid Refused
Munitz/1983 (6) Male 84 10 Entire None
Carlisle/1984 (7) Male 14 2.5 Entire Bougienage*
Agarwal/1990 (8) Male 37 22 Entire Unknown
Male 50 40 Entire Bougienage*
Harrison/1992 (9) Male 35 Lifelong Entire Bougienage*
Male 68 Lifelong Entire Refused
Bousvaros/1992 (10) Male 15 ns Entire AA+H2RA
Male 13 ns Entire AA+H2RA
Male 14 ns Distal third AA+H2RA
Male 17 ns Distal third AA+H2RA
Male 18 ns Entire AA+H2RA
Female 9 ns Entire t
Present report Male 27 1 month Mid Bougienage

*Experienced an unusual degree of pain or bleeding; TRings disappeared after fundoplication. AA+H2RA Antacids and H2-receptor antagonists; ns Not stated
Time to visit a trusted pharmacy – buy birth control to begin your treatment now.

This entry was posted in Dysphagia and tagged Dysphagia, Esophagus, Rings, Webs.