Research Article
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Proksimal Özofagusta Heterotopik Gastrik Mukoza Prevalansı ve Klinik ve Endoskopik Bulgular Arasındaki İlişki

Year 2019, Volume: 9 Issue: 4, 338 - 342, 31.12.2019
https://doi.org/10.16899/jcm.626167

Abstract

Amaç

Heterotopik gastrik mukoza (HGMPE), genellikle proksimal
özofagusta lokalize olan ektopik gastrik mukoza adasıdır. HGMPE' nin klinik
önemi esas olarak asit üretimi ve neoplastik dönüşüm  kapasitesi ile ilişkilidir. Bu çalışmada
HGMPE prevalansı ile klinik ve endoskopik bulgular arasındaki ilişkiyi
araştırmayı amaçladık.

Yöntem

Aralık 2013 ile Şubat 2018 arasında Acıbadem Kayseri Hastanesi gastroenteroloji ünitesinde özofagogastroduodenoskopi
yapılan 2091 kadın ve 2035 erkek toplam 4126 hasta retrospektif olarak tarandı.
54 kadın ve 68 erkekten oluşan toplam 122 HGMPE + hasta ile yaş ve cinsiyet
açısından eşleştirilmiş 107 kadın ve 134 erkekten oluşan toplam 241 kişilik
HGMPE - kontrol grubu çalışmaya dahil edildi.

Bulgular

Çalışmamızda HGMPE prevalansını % 2.96 olarak saptadık.
Disfaji, hasta grubunda anlamlı olarak yüksek iken, kontrol grubunda abdominal
ağrı daha fazlaydı. HGMPE + ve HGMPE – gruplar arasında reflü özofajit,
duodenal ülser ve alt özofageal sfinkter eksikliği açısından istatistiksel
olarak anlamlı bir fark bulunmadı.

Sonuç

Çalışmalar arasındaki çelişkilere rağmen, eğer endoskopist
bu durumun farkında olursa  HGMPE'nin
daha sık rastlanan bir endoskopik bulgu olabileceğini düşünüyoruz. Bu durumun
klinik önemi ile ilgili tartışmalar devam etse de, artan sayıda neoplastik
transformasyon HGMPE'nin önemini daha da artırmıştır.

















Anahtar
kelimeler:
Heterotopik gastrik mukoza, Servikal
inlet patch, Özofagus, Laringofaringeal reflü, Disfaji.

References

  • Referans1 von Rahden BH, Stein HJ, Becker K et al. Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopathologic classification. Am J Gastroenterol 2004; 99: 543–551.
  • Referans2 Chong VH. Heterotopic gastric mucosal patch of the proximal esophagus. Gastrointestinal Endoscopy 2011; 125–148
  • Referans3 Borhan-Manesh F, Farnum JB. Incidence of heterotopic gastric mucosa in the upper oesophagus. Gut 1991; 32: 968–972
  • Referans4 Orizio P, Villanacci V, Bassotti G et al. Heterotopic gastric mucosa in the cystic duct. Int. J. Surg. Pathol 2011; 19: 364–365
  • Referans5 Mann NS, Mann SK, Rachut E. Heterotopic gastric tissue in the duodenal bulb. J. Clin. Gastroenterol 2000; 30: 303–306
  • Referans6 Jarry J, Rault A, Sa Cuhna A et al. Acute recurrent pancreatitis by heterotopic fundic mucosa at the ampulla of vater. Pancreas 2009; 38: 351–353
  • Referans7 Rifat Mannan AA, Kahvic M, Bharadwaj S etal. Gastric heterotopia of the anus: report of two rare cases and review of the literature. Indian J. Pathol. Microbiol 2008; 51: 240–241
  • Referans8 Avidan B, Sonnenberg A, Chejfec G et al. Is there a link between cervical inlet patch and Barrett’s esophagus? Gastrointest Endosc 2001; 53: 717–721
  • Referans9 Meining A, Bajbouj M. Erupted cysts in the cervical esophagus result in gastric inlet patches. Gastrointest Endosc 2010; 72: 603–605
  • Referans10 Takeji H, Ueno J, Nishitani H. Ectopic gastric mucosa in the upper esophagus: prevalence and radiologic findings. Am. J. Roentgenol 1995; 164: 901–904
  • Referans11 Rector LE, Connerly ML. Aberrant mucosa in the esophagus in infants and in children. Arch. Pathol 1941; 31: 285–294
  • Referans12 Truong LD, Stroehlein JR, McKechnie JC. Gastric heterotopia of the proximal esophagus: a report of four cases detected by endoscopy and review of literature. Am. J. Gastroenterol 1986; 81: 1162–1166
  • Referans13 Schroeder WW, Myer III CM, Schechter GL. Ectopic gastric mucosa in the cervical esophagus. Laryngoscope 1987; 97: 131–135
  • Referans14 Taylor AL. The epithelial heterotopias of the alimentary tract. J. Pathol 1927; 30: 415–449
  • Referans15 Chong VH. Clinical significance of heterotopic gastric mucosal patch of the proximal esophagus. World J Gastroenterol 2013; 193): 331-338
  • Referans16 Akbayir N, Alkim C, Erdem L et al. Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics. J Gastroenterol Hepatol 2004; 19: 891–896
  • Referans17 Lauwers GY, Scott GV, Vauthey JN. Adenocarcinoma of the upper esophagus arising in cervical ectopic gastric mucosa: rare evidence of malignant potential of so-called “inlet patch” Dig. Dis. Sci 1998; 43: 901–907
  • Referans18 Gutierrez O, Akamatsu T, Cardona H et al. Helicobacter pylori and hetertopic gastric mucosa in the upper esophagus (the inlet patch) Am J Gastroenterol 2003; 98: 1266–1270
  • Referans19 Alagozlu H, Simsek Z, Unal S et al. Is there an association between Helicobacter pylori in the inlet patch and globus sensation? World J. Gastroenterol 2010; 16: 42–47
  • Referans20 Ward EM, Achem SR. Gastric heterotopia in the proximal esophagus complicated by stricture. Gastrointest Endosc 2003; 57: 131–133
  • Referans21 Buse PE, Zuckerman GR, Balfe DM. Cervical esophageal web associated with a patch of heterotopic gastric mucosa. Abdom Imaging 1993; 18: 227–228
  • Referans22 Bataller R, Bordas JM, Ordi J et al. Upper gastrointestinal bleeding: a complication of “inlet patch mucosa” in the upper esophagus. Endoscopy 1995; 27: 282
  • Referans23 Katsanos KH, Christodoulou DK, Kamina S et al. Diagnosis and endoscopic treatment of esophago-bronchial fistula due to gastric heterotopy. World J. Gastrointest Endosc 2010; 2: 138–142
  • Referans24 García AO, Mazzadi SA, Raffo L et al. Heterotopic gastric mucosa in the upper esophagus: report of a case with a fistula. Dis Esophagus 2002; 15: 262–265
  • Referans25 Righini CA, Faure C, Karkas A et al. Spontaneous perforation in the upper oesophagus resulting from ulcer in heterotopic gastric mucosa. Rev. Laryngol Otol Rhinol (Bord) 2007; 128: 197–200
  • Referans26 Sahin G, Adas G, Koc B et al. Is Cervical Inlet Patch Important Clinical Problem? Int J Biomed Sci 2014; 10(2): 129-35
  • Referans27 Neumann WL, Luján GM, Genta RM. Gastric heterotopia in the proximal oesophagus (“inlet patch”): Association with adenocarcinomas arising in Barrett mucosa. Dig Liver Dis 2012; 44: 292–296
  • Referans28 Chong VH, Jalihal A. Heterotopic gastric mucosal patch of the esophagus is associated with higher prevalence of laryngopharyngeal reflux symptoms. Eur Arch Otorhinolaryngol 2010; 267: 1793–1799.
  • Referans29 Weickert U, Wolf A, Schröder C et al. Frequency, histopathological findings, and clinical significance of cervical heterotopic gastric mucosa (gastric inlet patch): a prospective study in 300 patients. Dis Esophagus 2011; 24: 63–68
  • Referans30 Jacobs E, Dehou MF. Heterotopic gastric mucosa in the upper esophagus: a prospective study of 33 cases and review of literature. Endoscopy 1997; 29: 710–715
  • Referans31 Yüksel I, Usküdar O, Köklü S et al. Inlet patch: associations with endoscopic findings in the upper gastrointestinal system. Scand J Gastroenterol 2008; 43: 910–914
  • Referans32 Poyrazoglu OK, Bahcecioglu IH, Dagli AF et al. Heterotopic gastric mucosa (inlet patch): endoscopic prevalence, histopathological, demographical and clinical characteristics. Int J Clin Pract 2009; 63: 287–291
  • Referans33 Baudet JS, Alarcón-Fernández O, Sánchez Del Río A et al. Heterotopic gastric mucosa: a significant clinical entity. Scand J Gastroenterol 2006; 41:1398–1404

The Prevalence of Heterotopic Gastric Mucosa of the Proximal Esophagus and the Relationship Between Clinical and Endoscopic Findings

Year 2019, Volume: 9 Issue: 4, 338 - 342, 31.12.2019
https://doi.org/10.16899/jcm.626167

Abstract

Purpose

In this study, we aimed
to investigate the prevalence of HGMPE and the relationship between clinical
and endoscopic findings.

 Patients
and Methods

Between December 2013 and February
2018, a total of 4126 patients, 2091 women and 2035 men, who underwent
esophagogastroduodenoscopy in the gastroenterology unit of
Acıbadem Kayseri Hastanesi were retrospectively screened.

Totally, 122 patients, 54 women and
68 men found to have heterotopic gastric mucosa and a control group of age and
sex matched 241 patients, 107 women and 134 men who do not have heterotopic
gastric mucosa were included the study.

Results

We found the prevalence of HGMPE
2.96 % in our study. Dysphagia was significantly higher in the case group,
whereas abdominal pain was higher in the control group.

Conclusion





















Because of the controversies among
the studies we think that HGMPE may be a frequent finding if the endoscopist be
aware of this entity. Although the controversies remain regarding the clinical
significance of this entity, increasing number of cases of neoplastic
transformation has further increased the importance of HGMPE.

References

  • Referans1 von Rahden BH, Stein HJ, Becker K et al. Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopathologic classification. Am J Gastroenterol 2004; 99: 543–551.
  • Referans2 Chong VH. Heterotopic gastric mucosal patch of the proximal esophagus. Gastrointestinal Endoscopy 2011; 125–148
  • Referans3 Borhan-Manesh F, Farnum JB. Incidence of heterotopic gastric mucosa in the upper oesophagus. Gut 1991; 32: 968–972
  • Referans4 Orizio P, Villanacci V, Bassotti G et al. Heterotopic gastric mucosa in the cystic duct. Int. J. Surg. Pathol 2011; 19: 364–365
  • Referans5 Mann NS, Mann SK, Rachut E. Heterotopic gastric tissue in the duodenal bulb. J. Clin. Gastroenterol 2000; 30: 303–306
  • Referans6 Jarry J, Rault A, Sa Cuhna A et al. Acute recurrent pancreatitis by heterotopic fundic mucosa at the ampulla of vater. Pancreas 2009; 38: 351–353
  • Referans7 Rifat Mannan AA, Kahvic M, Bharadwaj S etal. Gastric heterotopia of the anus: report of two rare cases and review of the literature. Indian J. Pathol. Microbiol 2008; 51: 240–241
  • Referans8 Avidan B, Sonnenberg A, Chejfec G et al. Is there a link between cervical inlet patch and Barrett’s esophagus? Gastrointest Endosc 2001; 53: 717–721
  • Referans9 Meining A, Bajbouj M. Erupted cysts in the cervical esophagus result in gastric inlet patches. Gastrointest Endosc 2010; 72: 603–605
  • Referans10 Takeji H, Ueno J, Nishitani H. Ectopic gastric mucosa in the upper esophagus: prevalence and radiologic findings. Am. J. Roentgenol 1995; 164: 901–904
  • Referans11 Rector LE, Connerly ML. Aberrant mucosa in the esophagus in infants and in children. Arch. Pathol 1941; 31: 285–294
  • Referans12 Truong LD, Stroehlein JR, McKechnie JC. Gastric heterotopia of the proximal esophagus: a report of four cases detected by endoscopy and review of literature. Am. J. Gastroenterol 1986; 81: 1162–1166
  • Referans13 Schroeder WW, Myer III CM, Schechter GL. Ectopic gastric mucosa in the cervical esophagus. Laryngoscope 1987; 97: 131–135
  • Referans14 Taylor AL. The epithelial heterotopias of the alimentary tract. J. Pathol 1927; 30: 415–449
  • Referans15 Chong VH. Clinical significance of heterotopic gastric mucosal patch of the proximal esophagus. World J Gastroenterol 2013; 193): 331-338
  • Referans16 Akbayir N, Alkim C, Erdem L et al. Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics. J Gastroenterol Hepatol 2004; 19: 891–896
  • Referans17 Lauwers GY, Scott GV, Vauthey JN. Adenocarcinoma of the upper esophagus arising in cervical ectopic gastric mucosa: rare evidence of malignant potential of so-called “inlet patch” Dig. Dis. Sci 1998; 43: 901–907
  • Referans18 Gutierrez O, Akamatsu T, Cardona H et al. Helicobacter pylori and hetertopic gastric mucosa in the upper esophagus (the inlet patch) Am J Gastroenterol 2003; 98: 1266–1270
  • Referans19 Alagozlu H, Simsek Z, Unal S et al. Is there an association between Helicobacter pylori in the inlet patch and globus sensation? World J. Gastroenterol 2010; 16: 42–47
  • Referans20 Ward EM, Achem SR. Gastric heterotopia in the proximal esophagus complicated by stricture. Gastrointest Endosc 2003; 57: 131–133
  • Referans21 Buse PE, Zuckerman GR, Balfe DM. Cervical esophageal web associated with a patch of heterotopic gastric mucosa. Abdom Imaging 1993; 18: 227–228
  • Referans22 Bataller R, Bordas JM, Ordi J et al. Upper gastrointestinal bleeding: a complication of “inlet patch mucosa” in the upper esophagus. Endoscopy 1995; 27: 282
  • Referans23 Katsanos KH, Christodoulou DK, Kamina S et al. Diagnosis and endoscopic treatment of esophago-bronchial fistula due to gastric heterotopy. World J. Gastrointest Endosc 2010; 2: 138–142
  • Referans24 García AO, Mazzadi SA, Raffo L et al. Heterotopic gastric mucosa in the upper esophagus: report of a case with a fistula. Dis Esophagus 2002; 15: 262–265
  • Referans25 Righini CA, Faure C, Karkas A et al. Spontaneous perforation in the upper oesophagus resulting from ulcer in heterotopic gastric mucosa. Rev. Laryngol Otol Rhinol (Bord) 2007; 128: 197–200
  • Referans26 Sahin G, Adas G, Koc B et al. Is Cervical Inlet Patch Important Clinical Problem? Int J Biomed Sci 2014; 10(2): 129-35
  • Referans27 Neumann WL, Luján GM, Genta RM. Gastric heterotopia in the proximal oesophagus (“inlet patch”): Association with adenocarcinomas arising in Barrett mucosa. Dig Liver Dis 2012; 44: 292–296
  • Referans28 Chong VH, Jalihal A. Heterotopic gastric mucosal patch of the esophagus is associated with higher prevalence of laryngopharyngeal reflux symptoms. Eur Arch Otorhinolaryngol 2010; 267: 1793–1799.
  • Referans29 Weickert U, Wolf A, Schröder C et al. Frequency, histopathological findings, and clinical significance of cervical heterotopic gastric mucosa (gastric inlet patch): a prospective study in 300 patients. Dis Esophagus 2011; 24: 63–68
  • Referans30 Jacobs E, Dehou MF. Heterotopic gastric mucosa in the upper esophagus: a prospective study of 33 cases and review of literature. Endoscopy 1997; 29: 710–715
  • Referans31 Yüksel I, Usküdar O, Köklü S et al. Inlet patch: associations with endoscopic findings in the upper gastrointestinal system. Scand J Gastroenterol 2008; 43: 910–914
  • Referans32 Poyrazoglu OK, Bahcecioglu IH, Dagli AF et al. Heterotopic gastric mucosa (inlet patch): endoscopic prevalence, histopathological, demographical and clinical characteristics. Int J Clin Pract 2009; 63: 287–291
  • Referans33 Baudet JS, Alarcón-Fernández O, Sánchez Del Río A et al. Heterotopic gastric mucosa: a significant clinical entity. Scand J Gastroenterol 2006; 41:1398–1404
There are 33 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Hatice Karagöz 0000-0002-9891-5211

Ahmet Karaman This is me 0000-0002-0612-8078

Publication Date December 31, 2019
Acceptance Date November 23, 2019
Published in Issue Year 2019 Volume: 9 Issue: 4

Cite

AMA Karagöz H, Karaman A. The Prevalence of Heterotopic Gastric Mucosa of the Proximal Esophagus and the Relationship Between Clinical and Endoscopic Findings. J Contemp Med. December 2019;9(4):338-342. doi:10.16899/jcm.626167