Modern Pediatrics. Ukraine. (2023). 6(134): 171-175. doi 10.15574/SP.2023.134.171
Pavlykivska B. M.¹, Palyvoda A. P.², Kocherha Z. R.^1
1Ivano-Frankivsk National Medical University, Ukraine
²Treatment and diagnostic center «St. Luke’s Clinic», Ivano-Frankivsk, Ukraine

For citation: Pavlykivska BM, Palyvoda AP, Kocherha ZR. (2023). Heterotopia of the gastric mucosa in the esophagus among children (cases from practice). Modern Pediatrics. Ukraine. 6(134): 171-175. doi 10.15574/SP.2023.134.171.
Article received: Jul 17 2023. Accepted for publication: Oct 10, 2023.

Heterotopia of the gastric mucosa (inlet patch) is an atypical placement of the gastric mucosa in the upper or middle parts of the esophagus, a congenital anomaly that occurs as a result of a violation of tissue differentiation at an early embryonic stage, approximately at 4^th week of intrauterine development. Heterotopic gastric mucosa in the upper part of the esophagus is observed in adults in all age groups, its frequency ranges from 0.1% to 3.8%. The frequency of occurrence of this condition among children has been insufficiently studied.
Purpose – based on the analysis of clinical data, to familiarize doctors with cases of the inlet patch in the esophagus in children with recurrent dyspeptic and respiratory symptoms, regardless of the treatment.
Clinical cases. Cases of the inlet patch among adolescents with long-term dyspeptic and respiratory disorders are described. When conducting an endoscopic examination, the patients revealed spots of the inlet patch in the esophagus. Therefore, in patients with symptoms of upper esophageal dysphagia (lump in the throat, heartburn, sour taste, dysphagia, odynophagia, etc.), a gastroscopic examination should be performed especially carefully. The use of endoscopes with high resolution and electronic chronoscopy creates additional diagnostic possibilities when the іnlet patch is detected.
Conclusions. Heterotopic mucosa of the upper esophagus in childhood is diagnosed during fibroesophagogastroduodenoscopy for dyspeptic and espiratory disorders. A diverse clinical picture in the presence of spots in the inlet patch of the esophagus is caused by the production of hydrochloric acid by heterotopic cells of the gastric mucosa. Despite having treated patients who have complaints of recurrent dyspeptic and respiratory symptoms, one should be alert for a possible inlet patch during endoscopy of the upper gastrointestinal tract.
The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of parents and children was obtained for the study.
No conflict of interests was declared by the authors.
Keywords: heterotopia of the gastric mucosa, inlet patch, children.

REFERENCES

1. Akbayir N, Alkim C, Erdem L, Sökmen HM, Sungun A, Başak T et al. (2004, Aug). Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics. J Gastroenterol Hepatol. 19 (8): 891-896. https://doi.org/10.1111/j.1440-1746.2004.03474.x; PMid:15242492

2. Chen YR, Wu MM, Nan Q, Duan LP, Miao YL, Li XY. (2012, Jun). Heterotopic gastric mucosa in the upper and middle esophagus: 126 cases of gastroscope and clinical characteristics. Hepatogastroenterology. 59 (116): 1123-1125. doi: 10.5754/hge10703. PMID: 22580663.

3. Georges A, Coopman S, Rebeuh J, Molitor G, Rebouissoux L, Dabadie A et al. (2011, Apr). Inlet patch: clinical presentation and outcome in children. J Pediatr Gastroenterol Nutr. 52 (4): 419-423. https://doi.org/10.1097/MPG.0b013e3181f2a913; PMid:21240021

4. Gutierrez O, Akamatsu T, Cardona H, Graham DY, El-Zimaity HM. (2003, Jun). Helicobacter pylori and hetertopic gastric mucosa in the upper esophagus (the inlet patch). Am J Gastroenterol. 98 (6): 1266-1270. https://doi.org/10.1111/j.1572-0241.2003.07488.x; PMid:12818267

5. Jacobs E, Dehou MF. (1997, Oct). Heterotopic gastric mucosa in the upper esophagus: a prospective study of 33 cases and review of literature. Endoscopy. 29 (8): 710-715. https://doi.org/10.1055/s-2007-1004294; PMid:9427488

6. Oymaci E, Cengiz F, Ucar AD, Erkan N, Yildirim M. (2014). Heterotopic gastric mucosa of upper oesophagus: evaluation of 12 cases during gastroscopic examination. Prz Gastroenterol. 9 (5): 302-306. Epub 2014 Oct 19. https://doi.org/10.5114/pg.2014.45490; PMid:25396006 PMCid:PMC4223111

7. Talih T, Arslan E, Talih G, Sipahi M. (2020, Jun 8). Inlet patch mimicking unstable angina pectoris. Turk J Surg. 36 (2): 229-232. https://doi.org/10.5578/turkjsurg.4165; PMid:33015569 PMCid:PMC7515637

8. Tang P, McKinley MJ, Sporrer M, Kahn E. (2004, Apr). Inlet patch: prevalence, histologic type, and association with esophagitis, Barrett esophagus, and antritis. Arch Pathol Lab Med. 128 (4): 444-447. https://doi.org/10.5858/2004-128-444-IPPHTA; PMid:15043461