Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics.
OBJECTIVE
Heterotopic gastric mucosal patch, which has a 0.1-10% frequency, is encountered when the cervical esophagus is examined carefully during endoscopy. In this study, we aimed to determine the prevalence of the patch in the cervical esophagus, to identify its macroscopic and histological characteristics and to evaluate demographic and clinical features.


METHODS
Six hundred and sixty patients (317 male, 343 female; mean age 50.28 years, range 14-90) with upper gastrointestinal symptoms had elective esophagogastroduodenoscopy and the cervical esophagus was examined for the patch during withdrawal of the endoscope. Biopsies were obtained from the antrum and the patch. Helicobacter pylori was assessed using an immunohistochemical method.


RESULTS
The patch was found in 11 patients of 660, with a prevalence of 1.67%. Patch size ranged between 5 and 30 mm, appeared as a single patch in nine patients and as twin patches in two patients. Mean age and male : female ratio were not significantly different from the patient population without patches, but the female sex was predominant (three men, eight women; mean age 43.6 years, range 32-64). In five of 11 patients, the upper esophageal and laryngopharyngeal symptoms were remarkable. Eight patients in whom histological confirmation was carried out showed three fundic and five antral-type mucosa. Two of five patients with antral H. pylori also had the bacteria in the patch. H. pylori prevalence in the patch was 25%.


CONCLUSIONS
Heterotopic gastric mucosal patches in the proximal esophagus should not be overlooked during endoscopy because they may lead to important complications in relation to their acid secretion, which may vary according to their parietal cell mass.
Akbayir
Nihat
N
Department of Gastroenterology, Sisli Etfal Teaching and Research Hospital, Istanbul 81041, Turkey. akbayirn@hotmail.com
Alkim
Canan
C
Erdem
Levent
L
Sökmen
H Mehmet
HM
Sungun
Ayşim
A
Başak
Tülay
T
Turgut
Suat
S
Mungan
Zeynel
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002828:Choristoma / Q000175:diagnosis* / Q000473:pathology; D016145:Endoscopy, Digestive System; D004935:Esophageal Diseases / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D015995:Prevalence; D011446:Prospective Studies