SAFETY AND EFFECTIVENESS OF ENDOSCOPIC SAVARY-GILLIARD DILATOR IN PATERSON-BROWN-KELLY SYNDROME PATIENTS

Aims Paterson-Brown-Kelly syndrome (PBKS) is a rare entity characterized by iron-deficiency anemia, dysphagia, and upper esophageal webs. Treatment consists of mechanical dilation and iron supplementation. The aim of the study was to evaluate safety and effectiveness of Savary-Gilliard bougies dilation for the treatment of PBKS.

Methods This is a descriptive, retrospective study of PBKS patients followed up at a tertiary center from 2009 to 2018 who underwent endoscopic dilation of the web by Savary-Gilliard bougie dilator. For each patient, we collected clinical data, therapeutic procedure and outcome.

Results Twenty patients were enrolled with a median age of 47.36 years and a sex ratio of 0.05. The median duration of dysphagia was 39 months. Iron deficiency anemia was present in all patients with a mean value of hemoglobin of 8.6 g/dL. Upper endoscopy confirmed the presence of a web in the cervical oesophagus in 100% of cases. Treatment was based on iron supplementation followed by endoscopic dilatation with Savary-Gilliard dilators. There was no complication as serious bleeding or perforation after dilation session and endoscope passed through the esophagus easily. Dysphagia recurred in 4 patients after a median of 25.7 months.

Conclusions Our series confirms that endoscopic Savary-Gilliard dilation, associated with iron supplementation, is safe and effective for the management of esophageal webs in PBKS patients.

Publication History

Article published online:
14 April 2022