Safety and Effectiveness of Endoscopic Savary-Gillaard Bougies Dilation in Moroccan Plummer-Vinson Syndrome Patients

Salihoun, Mouna; Kabbaj, N.; Raissouni, F.; Chaoui, Z.; Acharki, Mohamed

doi:10.5402/2013/137895

Cited by 3 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The webs can be dilated using Savary-Guilard dilators [9] or TTS Balloon [4]. Choice depends on available dilators and infrastructure facilities.…”

Section: Discussionmentioning

confidence: 99%

“…Other disorders reported to be associated with this syndrome include Celiac disease, Crohn's disease, Rheumatoid arthritis and thyroid disease raising the possibility immune dysregulation may be involved in its pathogenesis although this remains to be proven [7,8]. The web is typically eccentric, located in post-cricoid esophagus can get ruptured unintentionally during diagnostic endoscopy if it is very thin or can be ruptured using variety of dilatation techniques using Savary Guilard dilators, TTS balloons, or electro-cautery [4,9,10]. For the first time, we report a purposeful use of the endoscope for rupturing the web.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patterson-Kelly Syndrome: A Single Centre Experience

Satarkar¹

2020

IJG

View full text Add to dashboard Cite

Background: Patterson Kelly syndrome is a rare entity, presenting with a triad of Iron deficiency anemia, Dysphagia and Esophageal webs. The syndrome is extremely rare and its incidence is decreasing probably due to improvements in nutritional standards. The syndrome is enigmatic in the sense that not all patients may be having anemia, the syndrome is associated with various autoimmune conditions, webs are located in post-cricoid region only and there is increased prevalence of upper gastrointestinal malignancies in these patients. The symptoms respond to iron replacement but many patients require rupture of web for relief of dysphagia. Savary dilators, TTS balloon, electro-cautery have been variably used to break the web. Objectives: 1. To study the profile of Patterson Kelly syndrome at our center; 2. To study if the endoscope itself can be used as effective dilator for rupturing the web; 3. To study the effect of iron replacement in these patients; 4. To study the occurrence of upper gastrointestinal malignancies in this condition. Material and methods: We report our experience of sixteen patients with Patterson Kelly syndrome over last fifteen years. This is a retrospective, single center, observational study. All patients had demonstrable web on endoscopy. The endoscope itself was used as a dilator to break the web in more than half of the patients. The endoscope being rigid instrument can easily break the thin web during diagnostic endoscopy itself. If the opening was too narrow, TTS balloon or Savary Guilard dilators were used. One patient had a perforation while using endoscope as the dilator. Five patients required more than one sitting of dilatation for achieving relief of dysphagia or for recurrent web formation. Most patients received intravenous iron supplementation. Ten patients had complete relief of dysphagia without recurrence. One patient had concomitant esophageal squamous cell carcinoma in lower esophagus which became evident when the scope was passed distally, post dilatation of the web. Conclusions: Although rare, Patterson Kelly syndrome continues to exist and can be effectively treated by iron replacement, dilatation and rupture of esophageal webs using various methods. The web can be ruptured by careful maneuvering of the endoscope itself. Intravenous iron replacement can be used prior to the procedure which can ameliorate the symptoms and reduce the need for the dilatation or can make it easier. Patients need surveillance for upper gastrointestinal malignancies however exact guidelines in this regard are lacking.

show abstract

“…The webs can be dilated using Savary-Guilard dilators [9] or TTS Balloon [4]. Choice depends on available dilators and infrastructure facilities.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patterson-Kelly Syndrome: A Single Centre Experience

Satarkar¹

2020

IJG

View full text Add to dashboard Cite

show abstract

“…of patients with PVS, and thus it has been suggested that yearly endoscopic controls should be performed for such patients [15,16]. Tissue iron plays a vital role in the propagation of epithelial cells.…”

Section: What Should the Clinician Ask Him/herself Or The Patient? Y mentioning

confidence: 99%

A Rare Case Report on Plummer-Vinson Syndrome with a Complication of Oral Cancer in a South-Asian Woman

Ayisha¹,

Ali²

2020

CMI

View full text Add to dashboard Cite

Plummer-Vinson syndrome (PVS), also called "Paterson-Brown-Kelly syndrome“, is a rare medical syndrome generally affecting middle-aged women. Iron deficiency anemia is the prime etiological factor and other probable factors include malnutrition, genetic predisposition, or autoimmune processes characterized by three distinctive features: iron deficiency anemia, dysphagia, and esophageal web. The dysphagia is generally painless and intermittent or progressive over years, restricted to solids, and associated with weight loss. The exact pathogenesis of PVS is still indistinguishable, but it is interconnected with iron deficiency anemia. Plummer-Vinson syndrome, if left untreated, carries an increased risk of developing squamous cell carcinoma of the upper alimentary tract.In this case report, a 40-year-old female patient presented long-standing dysphagia for months, which progressively developed to postcricoid squamous cell carcinoma by the time she approached to medical treatment. Diagnosis was confirmed through laboratory tests, showing iron deficiency anemia and whole-body positron emission tomography-computed tomography (PET-CT) presenting squamous cell carcinoma in postcricoid region (hypopharynx).

show abstract

“…The decline in reports and incidence of the syndrome may be related to the improvement in nutritional status and better treatment of iron deficiency (9). In Turkey, however, many Plummer-Vinson syndrome cases are still being reported (10,13,14). …”

mentioning

confidence: 99%