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SpringerPlus 2016Anal stricture is a disabling condition which is often unresponsive to conservative medical management. The complications of surgical procedures such as dilatations and...
BACKGROUND
Anal stricture is a disabling condition which is often unresponsive to conservative medical management. The complications of surgical procedures such as dilatations and anoplasty make it a formidable treatment challenge. Through this case, we report and explore a new medical treatment for ano-rectal strictures with an analogy to Plummer Vinson syndrome. A 69-year-old male presented with chronic constipation, rectal pain, and easy fatigability. The physical exam was negative for anal fissure and a digital rectal examination could not be completed because an index finger could not be advanced through the narrowed anus. Laboratory reports revealed microcytic hypochromic anemia with iron deficiency. A colonoscopy performed with a GIF XQ180 OLYMPUS scope, confirmed anal stricture with non-specific colitis. Conservative management with laxatives, high fiber diet, local anesthetics with a trial of mesalamine was initiated but the patient continued to have symptoms. He was referred to a hematologist for an evaluation of anemia and was started on intravenous (IV) iron infusion.
FINDINGS
The patient's symptoms of constipation, anal stricture and iron deficiency anemia resolved with iron infusion over 3 months. A repeat rectal exam was painless and confirmed resolution of anal stricture.
CONCLUSION
IV iron supplementation combined with conventional anal dilatation presents as a promising approach toward the treatment of anal strictures.
PubMed: 27917348
DOI: 10.1186/s40064-016-3629-8 -
Journal of the European Academy of... Nov 2016Koilonychia, a concave nail dystrophy, has multiple aetiologies and may be hereditary, acquired or idiopathic. Within dermatology, koilonychia is often a manifestation... (Review)
Review
Koilonychia, a concave nail dystrophy, has multiple aetiologies and may be hereditary, acquired or idiopathic. Within dermatology, koilonychia is often a manifestation of an inflammatory dermatosis such as psoriasis or lichen planus, or a sign of onychomycosis. Other disease associations include iron store abnormalities, Plummer-Vinson Syndrome, nutritional deficiencies and occupational or traumatic aetiologies. In young children, koilonychia of the toenails is commonly transient and idiopathic, although familial and syndromic cases are reported. The dermatologist must be aware of the potential cutaneous and systemic associations with koilonychia in order to guide appropriate workup, treatment and/or referral. An algorithm for evaluation of koilonychia is presented along with discussion of common causes of koilonychia and a comprehensive list of all known associations.
Topics: Diagnosis, Differential; Humans; Nail Diseases
PubMed: 27531645
DOI: 10.1111/jdv.13610 -
Gastrointestinal Endoscopy Nov 2016
Topics: Aged; Constriction, Pathologic; Electrosurgery; Esophageal Stenosis; Female; Humans; Hypopharynx; Pharyngeal Diseases; Plummer-Vinson Syndrome
PubMed: 27311656
DOI: 10.1016/j.gie.2016.06.003 -
Mayo Clinic Proceedings Mar 2016
Topics: Adult; Anemia; Comorbidity; Esophagus; Female; Hematinics; Humans; Plummer-Vinson Syndrome; Treatment Outcome
PubMed: 26944249
DOI: 10.1016/j.mayocp.2015.11.002 -
Clinical Case Reports Dec 2015Chronic iron deficiency can be associated with nail deformities like Koilonychia and Platynychia. It can also be associated with esophageal webs (Plummer-Vinson syndrome...
Chronic iron deficiency can be associated with nail deformities like Koilonychia and Platynychia. It can also be associated with esophageal webs (Plummer-Vinson syndrome or Patterson-Brown-Kelly syndrome) causing dysphagia in the patient. Though the pathogenesis of this association remains anecdotal and presence of these physical findings should prompt the clinician towards considering chronic iron deficiency as the cause of anemia.
PubMed: 26734146
DOI: 10.1002/ccr3.419 -
Journal of Gastrointestinal Surgery :... May 2016Plummer-Vinson Syndrome is a condition where iron deficiency is associated with difficulty swallowing due to the presence of an esophageal web. Deficiency of...
Plummer-Vinson Syndrome is a condition where iron deficiency is associated with difficulty swallowing due to the presence of an esophageal web. Deficiency of iron-dependent oxidative enzymes causes gradual degradation of the pharyngeal muscles which lead to mucosal atrophy and formation of webs. Although it is a very rare condition, an increased risk of esophageal squamous cell carcinoma makes its identification very important. Dilation of the esophageal web using a Savary dilator is a more effective and safer approach compared to conventional balloon dilation.
Topics: Dilatation; Esophagoscopy; Esophagus; Female; Humans; Middle Aged; Plummer-Vinson Syndrome; Rare Diseases
PubMed: 26658794
DOI: 10.1007/s11605-015-3051-5 -
The Turkish Journal of Gastroenterology... Jan 2016Plummer-Vinson syndrome (PVS) is characterized by the presence of postcricoid dysphagia, iron deficiency anemia, and upper esophageal web. This syndrome is now a rare... (Review)
Review
Plummer-Vinson syndrome (PVS) is characterized by the presence of postcricoid dysphagia, iron deficiency anemia, and upper esophageal web. This syndrome is now a rare condition because of the improvement in nutritional status and increased awareness regarding iron deficiency anemia and the early diagnosis and easy treatment of this anemia or underlying causes. In this presentation, we report two middle-aged female patients with PVS and briefly review the literature.
Topics: Anemia, Iron-Deficiency; Deglutition Disorders; Diagnosis, Differential; Esophageal Diseases; Esophagus; Female; Humans; Middle Aged; Plummer-Vinson Syndrome; Rare Diseases
PubMed: 26620961
DOI: 10.5152/tjg.2015.150435 -
Journal of Pediatric Gastroenterology... Nov 2015Plummer-Vinson syndrome (PVS), also called Kelly-Paterson syndrome, is a rare cause of dysphagia in children. This syndrome associates single or multiple webs in the...
OBJECTIVES
Plummer-Vinson syndrome (PVS), also called Kelly-Paterson syndrome, is a rare cause of dysphagia in children. This syndrome associates single or multiple webs in the upper esophagus with frequent iron deficiency.
METHODS
We reported 3 pediatric cases of PVS before analyzing all of the cases of PVS in children reported in the PubMed and EMBASE databases.
RESULTS
Among 17 reported PVS cases in children, all of the patients experienced iron-deficiency anemia, and no immunological disease was reported. The male/female ratio was 1/1.9, and most cases were observed in adolescents. Conversely to adults, endoscopic dilation was often necessary because dysphagia resisted iron supplementation. A single dilation was usually sufficient. One case of pediatric PVS experienced esophageal cancer in adulthood.
CONCLUSIONS
In the case of dysphagia in children, a swallow barium exploration with lateral incidence should look for PVS. Conversely to adults, an endoscopic dilation is frequently necessary to control dysphagia in children.
Topics: Adult; Anemia, Iron-Deficiency; Child; Child, Preschool; Deglutition Disorders; Endoscopy; Esophageal Neoplasms; Esophagus; Female; Humans; Male; Plummer-Vinson Syndrome
PubMed: 26502163
DOI: 10.1097/MPG.0000000000000842 -
Arquivos de Gastroenterologia 2015Plummer-Vinson syndrome is characterized by a triad of dysphagia, iron deficiency anemia and esophageal web. Most of the patients are middle aged women in the fourth to...
BACKGROUND
Plummer-Vinson syndrome is characterized by a triad of dysphagia, iron deficiency anemia and esophageal web. Most of the patients are middle aged women in the fourth to seventh decade of life.
OBJECTIVE
Very few cases of Plummer-Vinson syndrome affecting males have been reported. Here we report a series of male patients found to be suffering from Plummer-Vinson syndrome.
METHODS
Five males presented to us with dysphagia and fatigue of various durations, from April to August, 2012.
RESULTS
These patients were found to have iron deficiency anemia and esophageal web on subsequent investigations and were treated successfully with oral iron therapy.
CONCLUSION
Plummer-Vinson syndrome is common in both males and females and can be successfully treated with oral iron therapy. The patients have an increased risk of developing gastrointestinal malignancies and should be thoroughly evaluated for the same.
Topics: Adult; Anemia, Iron-Deficiency; Deglutition Disorders; Esophagoscopy; Esophagus; Humans; Iron; Male; Men's Health; Middle Aged; Plummer-Vinson Syndrome; Rare Diseases
PubMed: 26486296
DOI: 10.1590/S0004-28032015000300018 -
The Keio Journal of Medicine 2015
Topics: Bronchoscopy; Deglutition Disorders; Dietary Supplements; Female; Humans; Iron; Middle Aged; Plummer-Vinson Syndrome; Treatment Outcome
PubMed: 26411779
DOI: 10.2302/kjm.2014-0011-CR