21 yo female with dysphagia. Barium swallow shows circumferential radiolucent ring in upper esophagus. Proximal dilatation and jet phenomenon (Barium spurting through the ring on fluoroscopy) indicate partial obstruction.

Esophageal web:
A thin ring-like mucosal constriction projecting into the lumen
10% incidence at autopsy
Can be congenital or acquired
Most in hypopharynx and proximal esophagus
Majority protrude from anterior esophageal wall
Symptoms if lumen > 50% compromised

Sideropenic dysphagia (Plummer-Vinson syndrome)
-Iron deficiency anemia
-Esophageal web with dysphagia
-Increased incidence of carcinoma

If symptomatic, balloon dilatation; bougienage during esophagoscopy.

References:
1. Demos et al 2007: Esophagus I www.radiologyassistant.nl
2. Federle et al 2004: Diagnostic Imaging, Abdomen: Esophagus. AMIRSYS.

Credit: Dr Ahmed Haroun
http://www.radpod.org

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