A Classic Presentation of Plummer–Vinson Syndrome in Contemporary Gastroenterology Practice

Background: A cervical esophageal web is an uncommon cause of solid‑food dysphagia in adults and is frequently associated with iron‑deficiency anemia, often due to chronic gynecologic blood loss such as that from uterine fibroids.Case Presentation: A 43 - 45year‑old woman presented with a 4‑year history of intermittent dysphagia and choking on solids, heavy menstrual bleeding in clots, and no weight loss or gastrointestinal bleeding. She was profoundly anemic with hemoglobin 3.8 g/dL and marked microcytic hypochromic indices; iron studies confirmed severe iron deficiency with ferritin 1.81 ng/mL and transferrin saturation 1.3%. Pelvic ultrasonography revealed multiple uterine fibroids, the largest 10.8 × 8.4 cm. Barium swallow and upper endoscopy demonstrated a tight cervical esophageal web at 20 cm from the incisors, which was traversed and gently dilated using pediatric and then adult gastroscopes; histology showed mild active chronic esophagitis without dysplasia. She received packed red blood cell transfusions and intravenous iron (Encicarb) with improvement of hemoglobin to 10.6 g/dL and resolution of dysphagia. Once anemia was corrected, she was electively admitted and underwent open myomectomy for a markedly enlarged 22 to 24‑week‑size uterus, with removal of one 12‑cm fibroid and six smaller intramural fibroids. Postoperative recovery was uncomplicated and hemoglobin stabilized at 9.8 g/dL, with ongoing iron therapy planned to restore normal levels.Conclusion: This case highlights the association between severe iron‑deficiency anemia from fibroid‑related menorrhagia and cervical esophageal webs and highlights that combined iron repletion, endoscopic dilatation, and definitive surgical treatment of uterine fibroids can achieve rapid and sustained relief of dysphagia while preventing recurrent anemia.