Inlet patch: associations with endoscopic findings in the upper gastrointestinal system.

OBJECTIVE

Ectopic gastric tissue in the esophagus (inlet patch) mostly presents in the upper part of the esophagus and is usually under-diagnosed because of its localization. Little is known about its pathogenesis and significance. The aim of this study was to investigate whether there is an association between ectopic gastric tissue development and endoscopic features of the upper gastrointestinal tract, especially in the esophagus.

MATERIAL AND METHODS

A total of 9437 endoscopic examinations were analyzed prospectively. Endoscopic features and histological examinations of inlet patch and stomach specimens were documented. Endoscopic findings in patients with inlet patch were compared with those in patients without inlet patch.

RESULTS

Inlet patch was present in 171 (1.8%) of all patients. Forty-three (25.1%) patients with inlet patch and 519 (5.6%) patients without inlet patch had esophagitis (p = 0.000). Histologically proven Barrett's esophagus was more frequent among patients with inlet patch than among patients without inlet patch (3.5% versus 0.5%, p = 0.000). Prevalences of hiatal hernia in the two groups were similar. Open cardia was diagnosed more frequently in the inlet patch group than in the other group (24.5% versus 10.0%, p = 0.000). Helicobacter pylori colonization was detected in only 11% of inlet patch specimens, whereas 58% of stomach specimens from the same patients contained H. pylori colonies.

CONCLUSIONS

Patients with inlet patch seem to have predisposing factors for gastroesophageal reflux, and Barrett's esophagus is found more frequently in those patients. H. pylori colonization is involved in ectopic gastric tissue less frequently than in gastric tissue.