A review of the Plummer-Vinson stricture of the cervical oesophagus.

This note is written because of a belief that though the diagnosis of the Plummer-Vinson stricture is easy, still it is not being diagnosed; that though the treatment is straightforward and efficient, it is not yet thoroughly carried out; that though it can be prevented easily enough, it is not being prevented; that though it is well known to be pre-cancerous, the cancer is not being prevented. The Plummer-Vinson stricture is a simple, painless, permanent stricture in the cervical oesophagus, not associated with inflammation, swelling or ulceration, which causes obstructive dysphagia. Its anatomical forms, from thin web to long sleeve stricture, are best seen on x-ray examination and are described and illustrated in this supplement. It is usually formed during longstanding iron deficiency, and therefore it is much more common in women. It never shows spontaneous regression. Correction of iron deficiency and anaemia are believed to halt the process, and hinder progression to carcinoma, but such correction does not change the stricture, which remains as it was. The nomenclature has varied much. Until the eighteenth century it was included in the anginas, a name till then reserved for obstructions of breathing and swallowing above the clavicles. Cases with only mucosal atrophy or mucosal inflammation in the foregut, without obstructive dysphagia, should not be included in this stricture syndrome, related though such changes may be.