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CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2022; 12(01): 90-92
DOI: 10.1055/s-0041-1731141
Case Report

Symptomatic Heterotopic Gastric Mucosa in Distal Esophagus

Avnish Kumar Seth
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Mahesh Kumar Gupta
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Gursimran Kaur
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Priti Jain
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
,
Rinkesh Kumar Bansal
1   Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurugram, Haryana, India
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Abstract

Introduction Heterotopic gastric mucosa (HGM) in esophagus is commonly noted as an inlet patch at endoscopy. We describe a rare patient with symptomatic distal esophageal HGM.

Case Report A 40-year-old male presented with retrosternal pain and marked odynophagia for the last 4 weeks without any history of ingestion of antibiotics, foreign body, or corrosive. Endoscopy showed abrupt circumferential transition to salmon pink mucosa at 35 cm from incisors. From 35 to 41 cm, there were areas of polypoid edematous thickening with few superficial ulcers of 1 to 3 mm. Squamous epithelium was visualized at narrow band imaging from 41 cm to the Z-line at 43 cm with no hiatus hernia. Biopsy showed gastric-type mucosa with parietal cells without dysplasia. Serology for cytomegalovirus and human immunodeficiency virus was negative. He was managed with proton pump inhibitors (PPIs) and prokinetics and improved symptomatically. Follow-up endoscopy at 3 months demonstrated healing of ulcers with persistence of HGM and pseudopolyps. He remains well on maintenance with PPI at 1-year follow-up.

Conclusion Symptomatic HGM in distal esophagus is rare and can be differentiated from Barrett’s esophagus histologically and by presence of squamous epithelium between HGM and stomach. Inflammatory mass lesions may develop and mimic esophageal malignancy. Symptoms are largely due to acid production and usually respond to PPI.

Keywords

heterotopic gastric mucosa - distal esophagus - retrosternal pain


Publication History

Article published online:
14 June 2021

© 2021. Nitte (Deemed to be University). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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