title: Heterotopic gastric mucosa of the proximal oesophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics in paediatric patients.
abstract: BACKGROUND
  Heterotopic gastric mucosa is found in the proximal oesophagus, just below the upper oesophageal sphincter, and is encountered when the oesophagus is examined carefully during endoscopy.
  
  
  OBJECTIVE
  In this study on paediatric patients, we aimed to determine the endoscopic prevalence of heterotopic gastric mucosa of the proximal oesophagus (HGMPO), to identify its macroscopic and histological characteristics and to evaluate its clinical features.
  
  
  METHODS
  A total of 1399 patients were examined. Ages, sex, clinical and endoscopic findings of all patients were recorded. Patients with HGMPO were classified in accordance with a clinicopathological classification and information on the treatment and evolution was also recorded.
  
  
  RESULTS
  Of the 1399 patients, 20 (11 male) were found to have HGMPO. The prevalence of HGMPO was determined to be 1.4%. In five patients, the upper oesophageal and laryngopharyngeal symptoms were remarkable. The clinicopathological classification showed that 15 patients were HGMPO type 1 (asymptomatic) and five were type 2 (symptomatic without morphologic changes). There was no significant association of any other endoscopic finding with the presence of an HGMPO. Proton pump inhibitors treatment was initiated in 16 patients, including those with HGMPO type 2. In one type 2 patient who showed no improvement during medical treatment, endoscopic treatment was indicated (argon plasma ablation). In patients with symptoms attributable to the presence of the inlet patch, the proposed treatment resolved clinical symptoms.
  
  
  CONCLUSIONS
  The presence of HGMPO is not an infrequent finding in thorough endoscopies. Although HGMPO does not usually have a symptomatic progression, it can sometimes lead to supraoesophageal symptoms; thus, treatment should be considered.
authors.affiliation: Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rodríguez-Martínez
authors.forename: José C
authors.initials: JC
authors.lastname: Salazar-Quero
authors.forename: Carlos
authors.initials: C
authors.lastname: Tutau-Gómez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Espín-Jaime
authors.forename: María
authors.initials: M
authors.lastname: Rubio-Murillo
authors.forename: Antonia
authors.initials: A
authors.lastname: Pizarro-Martín
mesh_terms: D000293:Adolescent; D000367:Age Factors; D057908:Argon Plasma Coagulation; D058070:Asymptomatic Diseases; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002828:Choristoma / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D004935:Esophageal Diseases / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D005260:Female; D005753:Gastric Mucosa; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors