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
|Kelley/1966 (2)||Male||46||20||Upper and mid/four||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
|Janisch/1982 (5)||Male||42||5||Upper and mid||Bougienage|
|Male||42||17||Upper and mid||Refused|
|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
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