Heterotopic Gastric Mucosa in Cervical Oesophagus: Clinical Observations
https://doi.org/10.22416/1382-4376-2021-31-1-74-79
Abstract
Aim. Description of the endoscopic and clinical traits of heterotopic gastric mucosa (HGM) observed in cervical oesophagus.
Key points. HGM in proximal oesophagus can be asymptomatic or have various clinical manifestations. A 40-yo female patient consulted a gastroenterologist with complaints of cough and globus sensation. For several years she was visiting an otorhinolaryngologist and psychotherapist, with therapy ineffective. Esophagogastroduodenoscopy (EGDS) at the last visit revealed several foci of HGM in cervical oesophagus of 1.2 x 0.8 cm maximal size. The patient was prescribed a combined prokinetic — proton pump inhibitor therapy, which relieved the symptoms. EGDS in a 21-yo patient without active complaints revealed a 2 cm-wide HGM of 4/5 cervical oesophageal lining with acidproducing zones.
Conclusion. Two different scenarios of cervical oesophageal HGM are described, the first one manifested with laryngopharyngeal reflux, and the second devoid of clinical manifestations despite a large heterotopic site.
About the Authors
A. I. Dolgushina
South Ural State Medical University
Russian Federation
Russian Federation
Anastasia I. Dolgushina — Dr. Sci. (Med.), Prof., Departmental Head, Department of Hospital Terapy, South Ural State Medical University.
454048, Chelyabinsk, Vorovskogo str., 70.
A. O. Khikhlova
South Ural State Medical University; Chelyabinsk Regional Clinical Hospital
Russian Federation
Russian Federation
Alina O. Khikhlova — Doctor, Endoscopy Department, Chelyabinsk Regional Clinical Hospital.
454048, Chelyabinsk, Vorovskogo str., 70.
E. R. Olevskya
South Ural State Medical University; Chelyabinsk Regional Clinical Hospital
Russian Federation
Russian Federation
Elena R. Olevskya — Dr. Sci. (Med.), Ass. Prof., Departmental Head, Department of Hospital Surgery, South Ural State Medical University; Departmental Head, Endoscopy Department, Chelyabinsk Regional Clinical Hospital.
454048, Chelyabinsk, Vorovskogo str., 70.
O. V. Naumenko
Chelyabinsk Regional Clinical Hospital
Russian Federation
Russian Federation
Olga V. Naumenko — Doctor, Endoscopy Department, Chelyabinsk Regional Clinical Hospital.
454048, Chelyabinsk, Vorovskogo str., 70.
S. Yu. Belousov
Chelyabinsk Regional Clinical Hospital
Russian Federation
Russian Federation
Stanislav Y. Belousov — Doctor, Clinical Patomorphology Department, Chelyabinsk Regional Clinical Hospital. Contact information: nahtap@rambler.ru;
454048, Chelyabinsk, Vorovskogo str., 70.
References
1. Rusu R., Ishaq S., Wong T., Dunn J.M. Cervical inlet patch: new insights into diagnosis and endoscopic therapy. Frontline Gastroenterol. 2018;9(3):214—20. DOI: 10.1136/flgastro-2017-100855
2. Behrens C., Yen P.P. Esophageal inlet patch. Radiol Res Pract. 2011;2011:460890. DOI: 10.1155/2011/460890
3. Lopez-Colombo A., Jimenez-Toxqui M., Gogeascoechea-Guillen P.D., Melendez-Mena D., Morales-Hernandez E.R., Montiel-Jarquto A.J., Amaro-Balderas E. Prevalence of esophageal inlet patch and clinical characteristics of the patients. Rev Gastroenterol Mex. 2019;84(4):442—8. English, Spanish. DOI: 10.1016/j.rgmx.2018.07.003
4. Peitz U., Vieth M., Evert M., Arand J., Roessner A., Malfertheiner P. The prevalence of gastric heterotopia of the proximal esophagus is underestimated, but preneoplasia is rare — correlation with Barrett's esophagus. BMC Gastroenterol 2017;17:87. DOI: 10.1186/s12876-017-0644-3
5. von Rahden B.H., Stein H.J., Becker K., Liebermann-Meffert D., Siewert J.R. Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopatho-logic classification. Am J Gastroenterol. 2004;99(3):543— 51. DOI: 10.1111/j.1572-0241.2004.04082.x
6. Makushina A.A., Trukhmanov A.S., Storonova O.A., Pirogov S.S., Par-askevova A.V., Lapina T.L., Ivashkin V.T. A case report of a patient with multiple erosions of the esophagus and multiple acid-producing gastric heterotopia in the upper, middle and lower esophagus, contaminated by H. pylori in combination with chronic H. pylori-associated gastritis. Pediatric Nutrition. 2020;18(1):64-9 (In Russ.). DOI: 10.20953/1727-5784-2020-1-64-69
7. Meining A., Bajbouj M., Preeg M., Reichenberger J., Kassem A.M., Huber W., et al. Argon plasma ablation of gastric inlet patches in the cervical esophagus may alleviate globus sensation: a pilot trial. Endoscopy. 2006;38(6):566-70. DOI: 10.1055/s-2006-925362
8. Bajbouj M., Becker V., Eckel F., Miehlke S., Pech O., Prinz C., et al. Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations. Gastroenterology. 2009; 137(2):440-4. DOI: 10.1053/j.gastro.2009.04.053
9. Drossman D.A. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016 19:S0016-5085(16)00223-7. DOI: 10.1053/j.gastro.2016.02.032
10. Blanco C., Teusaba E., Russi K. A Case Report of Circumferential Presentation with Stricture of Heterotopic Gastric Mucosa in the Cervical Esophagus. Revi Col Gastroenterol. 2015;30(2):225—31.
11. Alagozlu H., Simsek Z., Unal S., Cindoruk M., Dumlu S., Dursun A. Is there an association between Helicobacter pylori in the inlet patch and globus sensation? World J Gastroenterol. 2010;16:42-7. DOI: 10.3748/wjg.v16.i1.42
12. Chong V.H., Jalihal A. Heterotopic gastric mucosal patch of the esophagus is associated with higher prevalence of laryngopharyngeal reflux symptoms. Eur Arch Otorhinolaryngol. 2010;267(11):1793-9. DOI: 10.1007/s00405-010-1259-2
13. Sahin G., Adas G., Koc B., Akcakaya A., Dogan Y., Goksel S., Yalcin O. Is cervical inlet patch important clinical problem? Int J Biomed Sci. 2014;10(2):129-35.
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For citations:
Dolgushina A.I., Khikhlova A.O., Olevskya E.R., Naumenko O.V., Belousov S.Yu. Heterotopic Gastric Mucosa in Cervical Oesophagus: Clinical Observations. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(1):74-79. (In Russ.) https://doi.org/10.22416/1382-4376-2021-31-1-74-79
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