Post on 22-Jul-2015
26 years old girl with menorrhagia & chronic ill health for many years.She started to have dysphagia for the last 2 years.O/E: she is pale with choenychia & mild splenomegaly.Ba-swallow reported to be normal but on better interpretation an upper esophageal web was evident.She underwnt baloon dilation of the upper esophageal web without any adverse sequele.
Pale patient recovering from GA after the intervention.
• This middle aged female presented with gradually progressive dysphagia
1- the patient is most probably suffering from………….2- you should proceed to the following investigations:A- B-
koilonychia Atrophic GlossitisAngular Stomatitis
? PLUMMER VINSON SYNDROME.2- The following investigations needed:A- Blood Picture (Hypochromic Anemia)B- Gastric secretion (achlorohydriaC- Barium Swallow (web)
• Plummer-Vinson or Paterson-Kelly syndrome presents as a classical triad of dysphagia, iron-deficiency anemia,
esophageal webs
Age: Middle age
Sex: 90% in females Etiology: Un-clear, may be
- iron deficiency anemia- Vitamin deficiency- or autoimmune processes
Pathology: Atrophy of :Pharyngeal
Esophageal &
Gastric mucosa
Symptoms
GeneralPharyngeal
Weakness, fatigue, and dyspneaare Secondary to iron deficiencyanemia
SignsGeneral
Pharyngeal
Dysphagia, if present, is typically
intermittent and limited to solids.
It is usually felt in the throat
Angular stomatitis
Glossitis
Atrophic glazed mucosa of the
hypopharynx
Koilonychia
Spleenomegaly
Pallor
Investigations
Complications
Treatment
- Stricture
- Pre-cancerous: postcricoid
carcinoma &esophageal carcinoma
Blood picture: hypochromic anemia
Gastric secretion: Achlorohydi due to atrophy of gastric mucosa
Barium swallow
Hypopharyngoscopy
Iron & vitamine supply
Repeated endoscopic dilatation
F/U for early detection of
postcricoid carcinoma &eso Ca.
Web
CXR: Normal.
14 years old girl, student from Rania,Presented with epigastric pain for 8 months duration, aggravated by meals & relieved by taking antispasmotic drugs.She had anorexia, weight loss, constipation.She was admitted many times to hospital & diagnosed having multiple GSs.He had opene cholecystectomy 2 months ago.Postop still she had epigastric & RH pain.She had many imagings & proved to have chronic pancreatitis.Family H/O her young brother died of rectal cancer with liver metastasis.