Esophagoscopy in the early detection and treatment of Plummer Vinson Syndrome
Background: To determine the role of esophagoscopy as a safe and cost-effective procedure which can be used for early diagnosis and treatment of Plummer Vinson Syndrome and prevent development of carcinoma of post-cricoid area. Methods: The study was carried out in E.N.T. department, Rawalpindi General Hospital, Rawalpindi. A total of 25 patients diagnosed with Plummer Vinson Syndrome presented to our department from July 2005 to June 2007 of which 23 patients were included in the study. 2 female patients were found to have carcinoma of hypopharynx and were excluded from the study. Blood CP, serum iron, barium swallow, esophagoscopy and biopsy was done in all the patients. Results: The ratio between female and male was found to be 10:1. Mean hemoglobin was 8 gm/dl. Average mean corpuscular volume (MCV) was 68.5%. Serum iron level was less than 40 ug/dl in females and less than 65 ug/dl in males. Web was seen on barium swallow in all the patients and was confirmed on esophagoscopy. Biopsy of esophageal web was taken in all patients. Biopsy of 2 female patients turned out to be squamous cell carcinoma of post-cricoid region while other 21 biopsies showed normal esophageal mucosa. Conclusion: Plummer Vinson Syndrome is still a common condition in females. Esophagoscopy, excision and dilatation of the web and iron replacement is safe and cost-effective procedure to diagnose and treat the disease. If untreated, may lead to serious complications like post-cricoid carcinoma.