Plummer Vinson Syndrome | Esophageal Obstructions
High Yield Points
• Also known as Paterson-Brown Kelly syndrome
• Occurs in middle aged edentulous (without teeth) women.
• Premalignant lesion (Approximately 10% of patients develop SCC of esophagus, oral cavity or the hypopharynx)
• Iron-deficiency anemia is a common finding (known as sideropenic dysphagia)
• Cause of dysphagia is usually a cervical esophageal web(Post-cricoid web) but abnormal pharyngeal and esophageal motility may play a role.
Investigations
1. CBC , Peripheral smear (hypochromic microcytic anemia) , iron studies
2. Barium swallow, videofluoroscopy , upper GI endoscopy.
Treatment
• Gentle dilatation, iron therapy and vitamins
• Esophageal web in Plummer-vinson syndrome is found at upper end of esophagus
• Schatzki’s ring is found at the lower end of esophagus.
MCQs
1. Patterson Brown Kelly syndrome is characterized by all except:
a. Lower esophageal web
b. Iron deficiency anemia
c. Common in adult female
d. Premalignant
e. a & c
2. Dysphagia in Plummer-Vinson syndrome is due to:
a. Post cricoids region commonly involved in web formation
b. Web is common in lower region
c. It is due to abnormal vessels
d. Web is common in middle zone
e. Decreased motility of esophagus
3. Not true about Plummer-Vinson syndrome is:
a. Occurs in elderly males
b. Post cricoids web
c. Predispose to hypopharynx malignancy
d. Koilonychia
4. Which of the following statement regarding Plummer-Vinson syndrome is not true?
a. It is otherwise know as Patterson-Brown Kelly disease
b. Iron deficiency anemia is probably the basic cause
c. It occurs exclusively in men
d. Prone to post cricoid cancer
5. In Plummer-Vinson syndrome, obstruction is due to:
a. Esophageal dysmotility
b. Esophageal stenosis
c. Post cricoid webs
d. None of the above
6. All are features of Plummer-Vinson syndrome except:
a. Esophageal web
b. Iron deficiency
c. Achalasia Cardia
d. Dysphagia
7. Not a feature of Plummer-Vinson syndrome:
a. Web present in lower part of esophagus
b. Koilonychia
c. Premalignant
d. Common in edentulous females
Ans. a. Web present in lower part of esophagus