Acid secreting gastric heterotopia in the duodenum.

Heterotopic gastric mucosa was found in the duodenum of a female patient with duodenitis and acid hyposecretion. The heterotopic isolated fundic glands were shown to accumulate 14C-aminopyrine in basal state and on stimulation with histamine suggesting that the heterotopic mucosa secreted acid. The ectopic acid secretion in the duodenal bulb suppressed gastric acid secretion, and might have caused the duodenitis and at least partly the clinical symptoms. The heterotopic gastric mucosa could be removed surgically by local excision. This procedure, combined with a Nissen fundoplication for suspected reflux oesophagitis, was followed by total symptomatic relief and normalization of gastric acid secretion.