Esophageal Webs and Rings

The esophagus is a muscular tube for the propulsion of food from the pharynx to the stomach. Histologically, the esophageal wall consists of mucosa, submucosa, and muscularis propria. Esophageal webs and rings are indentations of the esophageal wall that may partially occlude the esophageal lumen. Esophageal webs and rings are usually asymptomatic but can occasionally present with intermittent dysphagia to solids. Esophageal webs are classically associated with Plummer-Vinson syndrome (PVS). It includes the triad of iron-deficiency anemia, postcricoid dysphagia, and upper esophageal webs. Dysphagia is painless and slowly evolving, starting with solid foods and difficulty swallowing liquids after years of onset. Dysphagia becomes symptomatic only when the luminal diameter in the region of the esophageal web becomes less than 12 mm. Esophageal webs and rings are usually asymptomatic but can occasionally present with intermittent dysphagia to the solids. Dysphagia in PVS is generally graded I (occasional dysphagia on taking solids) or grade II (able to swallow only semi-solid diet).