Behrens C, Yen Peggy P W
Radiology Residency Program, University of British Columbia, Vancouver, BC, Canada V6T 1Z4.
Radiol Res Pract. 2011;2011:460890. doi: 10.1155/2011/460890. Epub 2011 Mar 30.
An inlet patch is a congenital anomaly consisting of ectopic gastric mucosa at or just distal to the upper esophageal sphincter. Most inlet patches are largely asymptomatic, but in problematic cases complications related to acid secretion such as esophagitis, ulcer, web and stricture may occur. The diagnosis of inlet patch is strongly suggested on barium swallow where the most common pattern consists of two small indentations on the wall of the esophagus. The diagnosis of inlet patch is confirmed via endoscopy with biopsy. At endoscopy, the lesion appears salmon-coloured and velvety and is easily distinguished from the normal grey-white squamous epithelium of the esophagus. The prominent margins correlate with the radiological findings of indentations and rim-like shadows on barium swallow. Histopathology provides the definitive diagnosis by demonstrating gastric mucosa adjacent to normal esophageal mucosa. No treatment is required for asymptomatic inlet patches. Symptomatic cases are treated with proton pump inhibitors to relieve symptoms related to acid secretion. Strictures and webs are treated with serial dilatation and should be biopsied to rule out malignancy.
入口斑是一种先天性异常，由食管上括约肌处或其远端的异位胃黏膜组成。大多数入口斑基本无症状，但在有问题的病例中，可能会出现与胃酸分泌相关的并发症，如食管炎、溃疡、蹼和狭窄。钡餐检查强烈提示入口斑的诊断，最常见的表现是食管壁上有两个小压痕。入口斑的诊断通过内镜检查及活检得以证实。在内镜检查中，病变呈鲑鱼色且表面光滑，很容易与食管正常的灰白色鳞状上皮区分开来。明显的边界与钡餐检查中压痕和边缘样阴影的影像学表现相关。组织病理学通过显示与正常食管黏膜相邻的胃黏膜来提供确诊依据。无症状的入口斑无需治疗。有症状的病例用质子泵抑制剂治疗以缓解与胃酸分泌相关的症状。狭窄和蹼采用系列扩张治疗，并应进行活检以排除恶性肿瘤。
