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食管上段异位胃黏膜:12例胃镜检查评估

Heterotopic gastric mucosa of upper oesophagus: evaluation of 12 cases during gastroscopic examination.

作者信息

Oymaci Erkan, Cengiz Fevzi, Ucar Ahmet Deniz, Erkan Nazif, Yildirim Mehmet

机构信息

Department of General Surgery, Izmir Training and Research Hospital, Izmir, Turkey.

出版信息

Prz Gastroenterol. 2014;9(5):302-6. doi: 10.5114/pg.2014.45490. Epub 2014 Oct 19.

Abstract

INTRODUCTION

Oesophageal heterotopic gastric mucosa mostly presents in the upper part of the oesophagus. It is commonly under-diagnosed because of its localisation.

AIM

To expose the association between heterotopic gastric mucosa and endoscopic features of the upper gastrointestinal tract.

MATERIAL AND METHODS

A total of 1860 upper endoscopic examinations performed between January 2012 and July 2013 were analysed retrospectively. Endoscopic features and histological examinations of 12 heterotopic gastric mucosa (HGM) of the upper oesophagus were documented and evaluated retrospectively.

RESULTS

There were 7 (58%) male and 5 (42%) female patients aged between 22 and 80 years with a mean age of 43.2 years. Heterotopic gastric mucosa was present in 12 (0.6%) of all patients. We were able to perform biopsy for histopathological observation on 8 (66%) of the 12 patients in which HGM was seen during endoscopy. Five (42%) patients with heterotopic gastric mucosa had oesophagitis. Los Angeles Grade A oesophagitis was found in all patients, and histologically proven Barrett's oesophagus was detected in only one patient.

CONCLUSIONS

When a patient has ongoing dyspeptic complaints and reflux symptoms despite the treatment, one should be careful about possible HGM during upper gastrointestinal endoscopy. The point to be taken into consideration for patients who have metaplasia or dysplasia within HGM may need to be considered for surveillance.

摘要

引言

食管异位胃黏膜多位于食管上段。由于其位置关系,常被漏诊。

目的

揭示异位胃黏膜与上消化道内镜特征之间的关联。

材料与方法

回顾性分析2012年1月至2013年7月期间进行的1860例上消化道内镜检查。对12例食管上段异位胃黏膜(HGM)的内镜特征和组织学检查进行回顾性记录和评估。

结果

共有7例(58%)男性和5例(42%)女性患者,年龄在22至80岁之间,平均年龄为43.2岁。所有患者中有12例(0.6%)存在异位胃黏膜。在内镜检查中发现HGM的12例患者中,我们能够对其中8例(66%)进行活检以进行组织病理学观察。5例(42%)异位胃黏膜患者患有食管炎。所有患者均为洛杉矶A级食管炎,仅1例经组织学证实为巴雷特食管。

结论

当患者尽管接受了治疗仍持续存在消化不良症状和反流症状时,在上消化道内镜检查期间应注意可能存在的HGM。对于HGM内有化生或发育异常的患者,可能需要考虑进行监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d6b/4223111/a0f138e09b39/PG-9-23567-g001.jpg

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