title: [Gastric heterotopia: clinical and histological study of 12 cases].
abstract: BACKGROUND
  Gastric heterotopia is a rare congenital lesion, described everywhere in the body, but involves predominantly the digestive tract. Diagnosis is based on histologic examination and requires the presence of gastric mucosa, especially fundic. This diagnosis is usually easy, but sometimes it can be misinterpreted as gastric metapalsia . This latter is an acquired and frequent lesion of the gastrointestinal tract.
  
  
  OBJECTIVE
  To determine the relationship between this affection and the other digestive malformations, to describe the clinical characteristics and the evolution of this lesion and to discuss the differential diagnosis particularly the gastric metaplasia.
  
  
  METHODS
  Twelve cases of gastric heterotopia were diagnosed over a 12-year period at Habib Thameur Hospital. Clinical data was obtained and all the slides were reviewed.
  
  
  RESULTS
  Nine cases were found in Meckel's diverticulum (75%), one case in intestinal duplication, one case in the esophagus and another in the gallbladder. The mean age of patients at diagnosis was 16 years with a peak of incidence at the first decade of life. Intestinal obstruction and digestive bleeding were the most presenting features. Heterotopic gastric mucosa complicates other congenital anomalies such as common mesentery, vestigial polyp of the liver, appendiceal agenesis and heterotopic pancreas. Differential diagnosis consists in gastric metaplasia was found extensively in a patient with Crohn's disease associated with Meckel's diverticulum.
  
  
  CONCLUSIONS
  Gastric heterotopia is frequently associated with congenital anomalies especially with Meckel's diverticulum and digestive duplication. Diagnosis relies on histology, mainly on finding heterotopic fundic glands in normal organizational structure. Sometimes, differentiating between gastric heterotopia and gastric metaplasia requires clinical confrontation.
authors.affiliation: Universite Tunis, EL Manar, Tunisie.
authors.forename: Ehsen
authors.initials: E
authors.lastname: Ben Brahim
authors.forename: Raja
authors.initials: R
authors.lastname: Jouini
authors.forename: Sana
authors.initials: S
authors.lastname: Aboulkacem
authors.forename: Farouk
authors.initials: F
authors.lastname: Jaouadi
authors.forename: Naceur
authors.initials: N
authors.lastname: Labbene
authors.forename: Raouf
authors.initials: R
authors.lastname: Cherif
authors.forename: Youssef
authors.initials: Y
authors.lastname: Helal
authors.forename: Sadok
authors.initials: S
authors.lastname: Sayed
authors.forename: Anis
authors.initials: A
authors.lastname: Ben Maamer
authors.forename: Aschraf
authors.initials: A
authors.lastname: Chadli-Debbiche
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002828:Choristoma / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004065:Digestive System Abnormalities / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D018450:Disease Progression; D004935:Esophageal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D008467:Meckel Diverticulum / Q000473:pathology; D008679:Metaplasia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach; D055815:Young Adult