Weingart J, Seib H J, Elster K, Ottenjann R
Leber Magen Darm. 1984 Jul;14(4):155-60.
Heterotopic gastric mucosa does occur in the upper gastrointestinal tract more often than has been thought up to now. Such heterotopic gastric mucosa was systematically looked for in inpatients and outpatients. Islets of heterotopic gastric mucosa were found in 125 patients in the cervical esophagus, in most cases a few centimeters below the esophageal entrance, and in 135 patients such islets of polypoid morphology were found in the duodenal bulbus. Histological analysis done in biopsy specimens taken from the cervical esophagus showed mucosa typical for the gastric corpus in 62 cases, a mixture of glandular tissue from the fundus and mucoid glands in 32 patients, and exclusively mucoid glands in 3 cases. Just superficial mucosa tissue (pits, epithelium) were found in 10 cases, in 14 patients the islets of gastric mucosa were not hit during the biopsy procedure, in 4 cases no biopsy was done. Heterotopic gastric mucosa tissue in the bulbus usually had a diameter of a few millimeters and polypoid morphology; these lesions were located postpylorically in the bulbus and measured more than 5 mm in diameter only in 10 cases. Whereas duodenal heterotopic gastric mucosa probably has no clinical relevance hydrochloric acid producing islets of gastric mucosa in the cervical esophagus may give rise to peptic lesions.
异位胃黏膜在上消化道的出现频率比目前认为的要高。我们对住院患者和门诊患者进行了系统的异位胃黏膜检查。在125例患者的颈段食管发现了异位胃黏膜岛,大多数情况下位于食管入口下方几厘米处;在135例患者的十二指肠球部发现了息肉样形态的异位胃黏膜岛。对取自颈段食管的活检标本进行组织学分析,62例显示为胃体典型的黏膜,32例为胃底腺组织与黏液腺的混合,3例仅为黏液腺。10例仅发现表层黏膜组织(小凹、上皮),14例在活检过程中未取到胃黏膜岛,4例未进行活检。十二指肠球部的异位胃黏膜组织通常直径为几毫米,呈息肉样形态;这些病变位于球部幽门后,直径超过5毫米的仅10例。虽然十二指肠异位胃黏膜可能无临床意义,但颈段食管产生盐酸的胃黏膜岛可能导致消化性病变。