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Syndrome de Plumer-Vinson traité par une dilatation endoscopique: une série de neuf cas

Plummer-Vinson syndrome successfully treated by endoscopic dilatation: a series of nine cases

  • Article Original / Original Article
  • Published:
Acta Endoscopica

Résumé

Le syndrome de Plummer-Vinson (SPV) ou de Kelly-Patterson, caractérisé par une dysphagie, une anémie hyposidérémique et un diaphragme sur l’oesophage cervical est extrêmement rare de nos jours. Bien que la correction de la sidéropénie pourrait améliorer ces symptômes, la dilatation endoscopique du diaphragme oesophagien associé est parfois nécessaire. Nous rapportons une série de neuf cas de SPV traités par dilatation endoscopique. Toutes les patientes avaient une histoire d’anémie et une dysphagie d’installation et d’aggravation progressive. La biologie a montré une anémie hypochrome, microcytaire et sidéropinique dans tous les cas. La fibroscopie oesogastroduodénale a montré un diaphragme au niveau de la région sous cricoïdienne. Toutes les patientes ont reçu un traitement substitutif en fer associé à une dilation endoscopique par des bougies de Savary (diamètre de 7 à 14 mm). Le diaphragme a été facilement détruit sans aucune complication. Cette dilatation a permis une disparition rapide de la dysphagie. Cependant, trois patientes ont présenté une récidive de la dysphagie associée à l’anémie. Ces patientes ont été retraitées avec sucées par une autre séance de dilatation endoscopique. Toutes les patientes ont été surveillées régulièrement avec une bonne évolution après un recul de 46 mois en moyenne. Notre expérience démontre que la dilatation endoscopique au cours du SPV est efficace, bien tolérée et relativement facile. Cependant, plusieurs séances sont parfois nécessaires

Abstract

Plummer-Vinson (Paterson-Brown-Kelly) syndrome, characterized by iron-deficiency anemia, upper esophageal webs, and dysphagia, is extremely uncommon nowadays. Although iron repletion improves its symptoms, endoscopic dilatation of associated esophageal webs is sometimes required. We report nine cases of Plummer-Vinson syndrome that were successfully treated by endoscopic dilatation. All patients had a history of anemia and slowly progressive dysphagia of solid food. Hematological tests showed iron deficiency anemia. Upper gastrointestinal endoscopy showed the presence of a web in the subcricoid region. All patients were treated with esophageal bougienage, and iron supplementation. Endoscopic bougienage was performed with the use of Celestin dilators of serially increasing diameters. The webs were easily disrupted without complications. The patient’s dysphagia resolved shortly after the treatment. However, three patients had a recurrence of dysphagia associated with anemia within an average of 8.3 months. These patients were successfully treated by a second endoscopic dilatation. All patients were examined periodically after the initial treatment and found to be in good general condition. This experience indicates that endoscopic dilatation is safe, effective, and relatively easy to perform in patients with Plummer-Vinson syndrome, although several sessions are sometimes necessary.

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Authors and Affiliations

  1. Service de gastroentérologie, EPS Hédi-Chaker, Sfax, Tunisie

    A. Amouri, L. Mnif, A. Mezghani, M. Ali Masmoudi & N. Tahri

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  1. A. Amouri
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  2. L. Mnif
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  3. A. Mezghani
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  4. M. Ali Masmoudi
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  5. N. Tahri
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Correspondence to A. Amouri.

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Amouri, A., Mnif, L., Mezghani, A. et al. Syndrome de Plumer-Vinson traité par une dilatation endoscopique: une série de neuf cas. Acta Endosc 41, 4–7 (2011). https://doi.org/10.1007/s10190-010-0132-x

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  • DOI: https://doi.org/10.1007/s10190-010-0132-x

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