Inlet patch: clinical presentation and outcome in children.
OBJECTIVE
An inlet patch (IP) is defined as heterotopic gastric mucosa located in the proximal esophagus. Little information is available in children. The aim of this retrospective study was to assess clinical significance, endoscopic and histological characteristics, and natural history of IP in children.


METHODS
This retrospective multicenter study included all of the cases of IP recorded in 7 tertiary French pediatric gastrointestinal centers. Information about demographics, clinical symptoms, endoscopic characteristics, histology, treatment, and evolution was collected.


RESULTS
Fifteen children were included (8 boys, 7 girls). The median age at diagnosis was 9.5 years (range 3.3-15 years). Five children had esophageal atresia and 9 had gastroesophageal reflux. Only 1 child was asymptomatic. Digestive symptoms (dysphagia, food impaction) were noted in 14 patients and respiratory or ear, nose, and throat symptoms in 6. At endoscopy, IP was characterized by a small, round salmon-pink lesion of the proximal esophagus. Helicobacter pylori was found in 2 patients. Proton pump inhibitor treatment was initiated in 14 children for a mean duration of 4.7 months (range 1-12 months). Two patients were lost to follow-up. Clinical symptoms disappeared in 5 patients and decreased in 3 others. One case of hematemesis was noted after a mean follow-up of 9 months. Recurrent symptoms were noted in 2 patients after treatment discontinuation.


CONCLUSIONS
IP is an uncommon but almost certainly underrecognized lesion in children, and may be the cause of digestive and respiratory symptoms in some children.
Department of Pediatric Gastroenterology, and Reference Center for Congenital and Malformative Esophageal Diseases, Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France.
Amandine
A
Georges
Stéphanie
S
Coopman
Julie
J
Rebeuh
Guy
G
Molitor
Laurent
L
Rebouissoux
Alain
A
Dabadie
Nicolas
N
Kalach
Alain
A
Lachaux
Laurent
L
Michaud
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002828:Choristoma / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D016099:Endoscopy, Gastrointestinal; D004933:Esophageal Atresia / Q000209:etiology; D004935:Esophageal Diseases / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005602:France; D005753:Gastric Mucosa / Q000473:pathology* / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D008297:Male; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies
D054328:Proton Pump Inhibitors