İnlet Patch Olgularının Retrospektif Tek Merkez Değerlendirilmesi

Year 2020, Volume: 28 Issue: Sayı: 3, 82 - 87, 30.12.2020

Ali Şenkaya Ferit Çelik Nalan Ünal Seymur Aslanov Murat Sezak Başak Doğanavşargil Ahmet Özütemiz

https://doi.org/10.17940/endoskopi.830763

Abstract

Giriş ve Amaç: İnlet patch, üst özofagus sfinkterinde veya hemen distalinde yer alan heterotopik gastrik mukoza adasıdır. Bu çalışmada amaç kliniğimizde inlet patch tanısı konulan vakaların sıklığı, demografik, klinik ve endoskopik özelliklerini değerlendirmektir. Gereç ve Yöntem: Bu çalışma Ocak 2015- Mart 2020 tarihleri arasında Gastroenteroloji Bilim Dalında herhangi bir nedenle özofagogastroduodenoskopi yapılıp, inlet patch tanısı konulan 245 hastanın retrospektif değerlendirilmesini içermektedir. Çalışmaya alınan hastaların; yaş, cinsiyet, endoskopi yapılma nedeni, inlet patch lezyonunun boyutu ve sayısı, Barrett özofagus, özofajit ve hiatus hernisi varlığı ve var olan patoloji sonuçları değerlendirilmiştir. Bulgular: İki yüz kırk beş hastada inlet patch bulunmuştur. İki yüz kırk beş hastanın 124’ü (%50.6) kadın, yaş ortalaması 48.64±14.54 yıldır. İnlet patch boyutunun ortalaması 13.32±8.85 (3-40) mm’dir. En sık endoskopi yapılma nedeni 91 (%37.1) hastada dispepsi olarak saptanmıştır. İnlet patch saptanan hastaların endoskopi sırasında 39’unda (%15.9) özofajit, 20’sinde (%8.2) hiatus hernisi ve 6’sında (%2.4) Barrett özofagus görülmüştür. Hastaların 125’inden (%51) biyopsi alınmış olup, 98 (%78.4) hastada patoloji ile uyumlu sonuçlanmıştır. Hastaların endoskopi yapılma nedenleri, Barrett özofagus ve hiatus hernisi varlığı ile inlet patch boyutu arasındaki istatistiksel olarak anlamlı farklılık olduğu saptanmıştır (sırasıyla; p=0.03, p=0.004, p=0016). Sonuç: Herhangi bir nedenle yapılan endoskopilerin %1.24’ünde inlet patch saptanmıştır. Merkezimiz üçüncü basamak bir sağlık kuruluşu olduğundan bu sonucun, Ege Bölgesi’nin inlet patch prevalansını yansıttığını düşünmekteyiz. Fonksiyonel dispepsi, disfaji, nedeni bilinmeyen kronik öksürüğü ve globusu olan hastalarda, servikal özofagus inlet patch açısından dikkatli bir şekilde incelenmelidir.

Keywords

Heterotopik gastrik mukoza, inlet patch, dispepsi

A Retrospective Single-Center Evaluation of Inlet Patch Cases

Abstract

Background and Aims: An inlet patch is an island of heterotopic gastric mucosa located in the upper or immediate distal part of the esophageal sphincter. The aim of this study was to evaluate the frequency, demographics, and clinical and endoscopic features of cases diagnosed with inlet patch in our clinic. Material and Methods: This retrospective study included 245 patients who underwent esophagogastroduodenoscopy for any reason in the department of gastroenterology between January 2015 and March 2020. The patients were evaluated on the basis of age, gender, reason for endoscopy, size and number of inlet patch lesions, presence of Barrett’s esophagus, esophagitis and hiatus hernia, and pathology results, if available. Results: İnlet patch was found in 245 of the endoscopies performed for any reason. Of the 245 patients, 124 (50.6%) were women, and the mean age was 48.64±14.54 (19-81) years. The mean size of inlet patch was 13.32±8.85 (3-40) mm. Dyspepsia was found to be the most common reason for endoscopy in 91 (37.1%) patients. Endoscopy revealed esophagitis in 39 (15.9%), hiatus hernias in 20 (8.2%), and Barrett’s esophagus in 6 (2.4%) patients among those detected to have inlet patch. A biopsy was taken from 125 (51%) patients, and the result was consistent with the reported pathology in 98 (78.4%) patients. A statistically significant difference was found between the inlet patch size and the reason for endoscopy, presence of Barrett’s esophagus, and presence of hiatus hernia (p=0.03, 0.004, and 0.016, respectively). Conclusion: İnlet patch was detected in 1.24% of endoscopies performed. Since ours is tertiary healthcare providing center, we consider that this result reflects the inlet patch prevalence of the Ege region in Turkey. The cervical esophagus should be carefully examined for the possibility of inlet patch in patients with functional dyspepsia, dysphagia, chronic cough with an unknown cause, and globus. Endoscopy should be repeated using narrow-band imaging technique after fully sedating the patients even if endoscopy has been performed before.

Keywords

Heterotopic gastric mucosa, inlet patch, dyspepsia

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