Plummer-Vinson syndrome vs Zenker diverticulum
How to tell Plummer-Vinson syndrome and Zenker diverticulum apart when a board question makes them look alike.
Plummer-Vinson is iron-deficiency web dysphagia; Zenker is food-trapping pouch with halitosis/regurgitation.
Side by side
Iron deficiency anemia with dysphagia from upper esophageal webs, sometimes with glossitis or koilonychia.
Pharyngoesophageal pouch with dysphagia, regurgitation of undigested food, chronic cough, aspiration, and halitosis.
Iron deficiency is associated with mucosal web formation in the upper esophagus.
Increased pressure and weakness near Killian triangle create a false diverticulum that traps food.
Microcytic iron deficiency plus cervical esophageal web supports Plummer-Vinson syndrome.
Barium swallow showing posterior outpouching above the upper esophageal sphincter supports Zenker diverticulum.
The trap
Both can cause dysphagia high in the esophagus, so anemia versus retained food symptoms separate them.
The repair move
When dysphagia feels cervical, ask whether the clue is iron-deficiency web or pouch-retained food.
Try a free question
CoreA patient with iron deficiency anemia has dysphagia from an upper esophageal web. Which syndrome is most likely?
Show answer and explanation
Answer: A. Plummer-Vinson syndrome. Plummer-Vinson syndrome is iron deficiency anemia with esophageal webs and dysphagia.
Why the other choices are tempting
- B. Zenker diverticulum is a pharyngoesophageal pouch with regurgitation and halitosis.
- C. Achalasia causes impaired LES relaxation and bird-beak narrowing.
- D. Eosinophilic esophagitis causes rings and food impaction in atopic patients.
- E. Adenocarcinoma is a distal gland-forming malignancy linked to Barrett risk.
Flashcards
Tap a card to flip it.
What triad defines Plummer-Vinson syndrome?
Iron deficiency anemia, dysphagia, and upper esophageal webs define the pattern.
What symptom cluster favors Zenker diverticulum?
Regurgitation of undigested food, halitosis, cough, or aspiration favors a food-trapping pouch.
Quick answers
What is the fastest way to tell Plummer-Vinson syndrome from Zenker diverticulum?
Plummer-Vinson is iron-deficiency web dysphagia; Zenker is food-trapping pouch with halitosis/regurgitation.
What is the key clue for Plummer-Vinson syndrome?
Iron deficiency anemia with dysphagia from upper esophageal webs, sometimes with glossitis or koilonychia.
What is the key clue for Zenker diverticulum?
Pharyngoesophageal pouch with dysphagia, regurgitation of undigested food, chronic cough, aspiration, and halitosis.
What is the common trap with Plummer-Vinson syndrome vs Zenker diverticulum?
Both can cause dysphagia high in the esophagus, so anemia versus retained food symptoms separate them.