Urquhart Siri A, Coelho-Prabhu Nayantara
Division of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Case Rep Gastrointest Med. 2020 Aug 20;2020:8822019. doi: 10.1155/2020/8822019. eCollection 2020.
Heterotopia is the presence of normal physiologic tissue in an atypical location. Gastric heterotopia has been described in various locations throughout the gastrointestinal tract, including the small intestine. Gastric heterotopia of the small intestine typically is asymptomatic but may present in several ways with symptoms of obstruction, bleeding, perforation, intussusception, or pain. However, gastric heterotopia is rare beyond the duodenum except for its frequent association with Meckel's diverticulum. This entity should be considered in the differential diagnosis of polypoid lesions presenting with symptoms of bleeding or obstruction especially in younger patients. We present a case of gastric heterotopia of the jejunum in a patient with a prior history of Meckel's diverticulectomy after he presented with obstructive symptoms. His symptoms improved following resection of two jejunal polyps via antegrade double-balloon assisted enteroscopy with fluoroscopy. On histopathlogical examination, findings were consistent with gastric heterotopia. This case highlights the importance of considering gastric heterotopia in the differential diagnosis of polypoid lesions located beyond the ligament of Treitz in younger patients presenting with obstructive symptoms.
异位是指正常生理组织出现在非典型位置。胃异位已在整个胃肠道的不同部位被描述过，包括小肠。小肠的胃异位通常无症状，但可能以多种方式表现出梗阻、出血、穿孔、肠套叠或疼痛等症状。然而，除了常与梅克尔憩室相关外，十二指肠以外的胃异位很少见。在鉴别诊断出现出血或梗阻症状的息肉样病变时，尤其是在年轻患者中，应考虑到这种情况。我们报告一例空肠胃异位病例，该患者既往有梅克尔憩室切除术史，此次因出现梗阻症状前来就诊。通过荧光透视下的顺行双气囊辅助小肠镜切除两个空肠息肉后，他的症状得到改善。组织病理学检查结果与胃异位一致。该病例强调了在鉴别诊断出现梗阻症状的年轻患者中，位于屈氏韧带以外的息肉样病变时考虑胃异位的重要性。
