Learning Radiology xray montage
 
 
 
 
 

Esophageal Web



 

  • Ringlike constriction of upper esophagus covered on superior and inferior surfaces by squamous epithelium
  • Three types have been described:
    • A non-specific or idiopathic web (most common)
    • Webs associated with Plummer-Vinson Syndrome
    • Webs associated with epidermolysis bullosa dystrophica or graft-versus-host disease
  • Usually found in middle-aged females
  • Plummer-Vinson Syndrome=Patterson-Kelly syndrome
    • Iron deficiency anemia
    • Stomatitis
    • Glossitis
    • Dysphagia
    • Spoon-shaped nails
    • Esophageal webs
    • Some question as to whether such a syndrome exists
  • Location
    • Cervical esophagus anteriorly at level of the cricopharyngeous (C5-C6)
    • Best visualized with maximal distension
    • Distal esophageal webs may arise from gastroesophageal reflux
  • Imaging Findings
    • Thin, transverse filling defects
    • Perpendicular to anterior esophageal wall
    • Usually less than 3mm in thickness
    • Frequently they are not circumferential
  • Increased risk of upper esophageal carcinoma
  • DDx
    • Prominent cricopharyngeous muscle
      • Arises posteriorly at C5-C6 and produces a much broader defect
    • Stricture
  • Treatment
    • Balloon dilatation
    • Bougienage during esophagoscopy

 Esophageal Web

 
Esophageal Web. Barium esophagram demonstrates a thin membrane arising from the anterior wall of the cervical esophagus at the level of C5-C6 without circumferential involvement of the lumen characteristic for an esophageal web

Halpert, R and Feczko, P: Requisites of Gastrointestinal Radiology, 2nd edition, 1999.