1. Esophageal webs in a 17-year-old male presenting with tablet impaction: a case report Tsaitas C, Sinakos E, Goulis J 4th Internal Medicine Unit, Ippokratio Hospital of Thessaloniki, Greece A 17-year-old male with free medical history presented with a food impaction sensation after pill indigestion and marked sialorrhea. 1

2. PATIENT HISTORY A thorough history revealed milk regurgitation in infancy and intermittent dysphagia, especially to meat, in adult life. 2

3. DIFFERENTIAL DIAGNOSIS Peptic stricture Esophageal tumor Extrinsic compression Mediastinal irradiation Pill-induced esophagitis and ulcers Achalasia Scleroderma 3

4. INVESTIGATION- TREATMENT The patient underwent an urgent esophagogastroduoedono scopy revealing an impacted tablet at the pharyngoesophageal junction, which was forcefully forwarded to the stomach. A circumferential membrane was noticed at 18 cm in the esophagus obstructing the endoscope to further proceed. Image 1. Esophageal web in the proximal esophagus of a 17-year-old patient. A Savary- Gilliard dilatation up to 11mm was performed and the patient was discharged. Two weeks after the procedure the patient remained asymptomatic with no reported dysphagia to fluids or solids. 4

5. CONCLUSION Esophageal webs are a rare cause of dysphagia but have to be taken into consideration when esophageal dysphagia is investigated. 5

6. Smith MS. Diagnosis and Management of Esophageal Rings and Webs. Gastroenterol Hepatol 2010;6(11):701-704 Carucci LR, Turner MA. Dysphagia revisited: common and unusual causes. Radiographics 2015;35(1):105-22 Gude D, Bansal D, Malu A. Revisiting plummer vinson syndrome. Ann Med Health Sci Res 2013;3(1):119-21 REFERENCES 6