Plummer-Vinson syndrome: improving outcomes with a multidisciplinary approach

Plummer-Vinson Syndrome and Role of Endoscopic Balloon Dilatation in a 4-Year-Old Child

Plummer-Vinson syndrome (PVS), also called Patterson-Kelly-Brown syndrome, is a rare cause of dysphagia in children. This syndrome is associated with single or multiple webs in the upper esophagus with frequent iron deficiency. PVS usually occurs in adults, particularly in Caucasian middle-aged women, in the fourth to seventh decade of life, and is rare in childhood. There are various theories about what causes PVS. One theory suggests that iron deficiency plays a crucial role in its development. Iron repletion often improves dysphagia, although some patients require esophageal dilatation or bougienage. Herein, we describe the case of a 4-year-old male child, having complaints of difficulty in swallowing solid food, diagnosed with PVS.

A Case of Plummer-Vinson Syndrome in an Omani Woman

Plummer-Vinson syndrome (PVS) is the triad of iron-deficiency anemia, esophageal webs and dysphagia. This article discusses the first reported case of PVS from Oman. A female patient in her 40s presented with a one-year history of dysphagia and odynophagia and a known background of untreated iron-deficiency anemia. After an elaborate workup, a diagnosis of PVS was made following visualization of the esophageal web with barium swallow study and esophagogastroduodenoscopy (EGD). A prompt and accurate diagnosis of PVS, although rare, is crucial, given that it is, at times, a precancerous condition. The treatment with iron therapy is the cornerstone of management, and it corrects the anemia as well as the dysphagia. If dysphagia persists, endoscopic dilation can be carried out.

Oral Cavity Squamous Cell Carcinoma Risk Factors: State of the Art

Head and neck (HN) squamous cell carcinomas (SCCs) originate from the epithelial cells of the mucosal linings of the upper aerodigestive tract, which includes the oral cavity, the pharynx, the larynx, and the sinonasal cavities. There are many associated risk factors, including alcohol drinking coupled with tobacco use, which accounts for 70% to 80% of HNSCCs. Human papilloma virus (HPV) is another independent risk factor for oropharyngeal SCC, but it is only a minor contributor to oral cavity SCC (OSCC). Betel quid chewing is also an established risk factor in southeast Asian countries. However, OSCC, and especially oral tongue cancer, incidence has been reported to be increasing in several countries, suggesting risk factors that have not been identified yet. This review summarizes the established risk factors for oral cavity squamous cell carcinomas and examines other undemonstrated risk factors for HNSCC.

Dysphagia in a patient with Plumer Vinson syndrome: An innovative surgical dilatation technique after failed endoscopy

For the last five years, a 43-year-old female presented with progressive dysphagia for solids and liquids. She was treated for iron deficiency anemia by systemic and oral iron therapy. Gastroenterologists failed to pass endoscopes through the upper esophagus. Gastrogrifin swallow revealed a critical narrowing of the esophagus. She was referred to a thoracic surgeon for further management. The cervical esophagus was exposed through the neck incision along the anterior border of the left sternocleidomastoid muscle, and esophageal dilatation was achieved using the silicon foleys catheter. It is a very safe and valuable surgical technique when dysphagia cannot be managed by endoscopically.

•

A 43 years old female know case of iron deficiency anemia.

•

Oral and intravenous iron replacements for two years.

•

Failed endoscopy examination due to unable to pass endoscope through esophagus.

•

Innovative surgical dilatation technique using foleys catheter.

The Missing Link: A Case of Plummer-Vinson Syndrome in a Young Pacific-Islander Woman With Helicobacter Pylori

Plummer-Vinson syndrome (PVS), the triad of dysphagia, iron-deficiency anemia (IDA), and esophageal webs, is a relatively rare disease entity that is mostly observed in the Caucasian populations of Scandinavia and North America. As these regions have become more developed with improved nutrition, PVS is now more commonly seen in the developing regions of the world.

We present the case of a 29-year-old Pacific-islander woman who presented with progressive dysphagia and IDA and was found to have an esophageal web and Helicobacter pylori (H. pylori) gastritis on upper endoscopy. She improved with dilation of the web in the esophagus and treatment of H. pylori. Identifying the possibility of this syndrome in clinical practice and the association between H. pylori and PVS, especially given recent changes in its epidemiology, is important given the patient population in Hawaii and the Pacific.