Endoscopy 2025; 57(S 02): S282
DOI: 10.1055/s-0045-1805686
Abstracts | ESGE Days 2025
ePosters

Instrumental stenosis dilatation and risk of esophageal cancer in Plummer Vinson syndrome

F Fares
1   Gastroenterology department, Fattouma Bourguiba Hospital, Monastir, Tunisia
,
A Guediche
2   Hospital University Fattouma Bourguiba, Monastir, Tunisia
,
M Abdelawahed
1   Gastroenterology department, Fattouma Bourguiba Hospital, Monastir, Tunisia
,
I Jemni
1   Gastroenterology department, Fattouma Bourguiba Hospital, Monastir, Tunisia
,
L Safer
1   Gastroenterology department, Fattouma Bourguiba Hospital, Monastir, Tunisia
› Author Affiliations
 

Aims Plummer Vinson syndrome is a rare entity. It is characterized by the existence of a cervical membrane leading to severe dysphagia.This syndrome is often accompanied by iron-deficiency anemia. The aim of this study is to determine the clinical characteristics of this disease and, above all, to analyze the therapeutic means, their indications and the efficacy of instrumental dilation of esophageal stenosis.

Methods A retrospective study over 21 years including all patients with Plummer Vinson syndrome diagnosed on clinical, radiological (esophageal transit data) and endoscopic criteria.

Results We collected 17 patients, divided into 16 women and one man, with a mean age of 44.43 years±13.9 with extremes from 19 to 74 years. Iron deficiency anemia was noted in 94.11% of cases (N=16).A drop in serum iron without associated anemia was noted in only one case. In 94.11% of cases, the anemia was revealed during exploration of upper dysphagia of organic origin, and in one case, isolated anemia in the absence of dysphagia.Endoscopy revealed an almost circumferential membranous Killian stenosis in 15 cases and a semi-membranous stenosis in two cases. A duodenal villous atrophy was not noted in our series. Post-dilation fibroscopy revealed a moderately differentiated adenocarcinoma of the gastric antrum (N=1), a bulbar ulcer (N=2), a benign gastric ulcer (N=1) and a sliding hiatal hernia (N=2). The barium swallow revealed a circumferential stenosis of the cervical esophagus in all cases, and a total of 24 dilation sessions were performed with a spark plug diameters ranging from 9 mm to 12,8 mm. The average number of dilation sessions was 1.46±1.26, with extremes of 0-4. Success was achieved in 11 cases (68.75%). Recurrence of dysphagia was noted in 5 cases (31.25%), after an average follow-up of 5 years. Another dilation session was successfully performed (N=4), but a rapid recurrence, 1 month after the second session, was noted in only one case,for which a third session was planned but not performed due to the fibroscopic finding of a tumor mass in the cervical esophagus related to a keratinizing squamous cell carcinoma. Oral martial therapy was indicated for all patients with iron-deficiency anemia and/or low serum iron, with favorable trend and disappearance of anemia in all cases. A recurrence after a 10-year follow-up was noted in one case.

Conclusions Plummer Vinson syndrome is an uncommon entity, found mainly in young adults, with a clear female predominance. Instrumental dilation, which is highly effective in this case, remains the essential treatment for dysphagia.Malignant transformation in Plummer Vinson syndrome is not as exceptional, so it should be borne in mind, particularly in cases of rapid recurrence of dysphagia after dilation [1] [2].



Publication History

Article published online:
27 March 2025

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