The Nature and Treatment of Plummer—Vinson Dysphagia

This syndrome of dysphagia of upper oesophageal type associated with present or past anaemia is relatively common in the North of Ireland.Treatment by dilata- tion is very satisfactory, but the condition is unfor- tunately often misdiagnosed as hysteria or "nervous swallow."Indeed, Vinson in 1922 put forward the view that the dysphagia was hysterical.We have been impressed by the diagnostic difficulty the condition evidently offers and by the consequent prolonged physical and social distress the patient suffers.That the condition is due to an organic stricture and that relief may be obtained by dilatation have been pointed out by McGibbon (1935), but these observations have not become widely known.This account is based on 16 cases observed in the last five years.Details of these cases are given in the Table. Clinical FeaturesThe clinical features have often been described, among others by McKenzie (1918), Brown Kelly (1919, 1927), Paterson (1919), and Munro Cameron (1928, 1929).The onset is insidious and the course lasts many years.There is no tendency to spontaneous cure.