ösophageales Web

Esophageal webs refer to an esophageal constriction caused by a thin mucosal membrane projecting into the lumen.

Epidemiology

Esophageal webs tend to affect middle-aged females.

Clinical presentation

Patients are usually asymptomatic and the finding may be incidental and unimportant. However, if the stenosis is severe symptoms include dysphagia and regurgitation of food.

Pathology

Location

More commonly occur in the cervical esophagus near cricopharyngeus muscle than in the thoracic esophagus. They typically arise from the anterior wall and never from the posterior wall; they can also be circumferential . Occasionally, multiple webs are visualized during maximal distension.

Associations

Radiographic appearance

Fluoroscopy: barium swallow
  • may be demonstrated on high-volume barium oesophagrams when the esophagus is fully distended
  • a "jet effect" of contrast passing distal to the web may be seen

Treatment and prognosis

An esophageal web may indicate an esophagus at higher risk of upper esophageal and hypopharyngeal carcinoma.

Treatment options include:

  • balloon dilatation
  • bougienage during endoscopy

Differential diagnosis

  • submucosal venous plexus: normal structure, noted anteriorly only as slightly irregular mucosa
  • Schatzki ring: occurs in the distal esophagus