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Dysphagia resulting from an upper esophageal web--a case report
R Nakamura1, M Watanabe, M Terashima
1First Department of Surgery, Iwate Medical University School of Medicine, Japan.
The Japanese Journal of Surgery
|November 1, 1991
Summary
A rare esophageal web caused severe dysphagia in a 69-year-old woman. Surgical removal provided a lasting solution after endoscopic treatments failed due to web regeneration.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Esophageal webs are rare congenital or acquired conditions causing dysphagia.
- Chronic inflammation can contribute to the formation of esophageal webs.
Observation:
- A 69-year-old female presented with severe chronic dysphagia due to a proximal esophageal web.
- Initial endoscopic rupture and bouginage provided temporary relief.
- The esophageal web regenerated within 6 months, becoming less distensible and resistant to further dilation.
Findings:
- Surgical excision revealed a firm, circumferential esophageal web composed of mucosa with chronic inflammation and submucosal fibrosis.
- Microscopic examination confirmed a transverse fold of esophageal mucosa with significant fibrous tissue proliferation.
Implications:
- Surgical intervention is effective for managing refractory esophageal webs causing severe dysphagia.
- Recurrence after endoscopic treatment highlights the potential for regenerative and fibrotic changes in esophageal webs.
- This case underscores the importance of surgical consideration for persistent or recurrent esophageal obstructions.