Gastric mucosa heterotopia of the proximal esophagus as a cause of respiratory distress in a newborn: case report

Main Article Content

Nathaly Hoepfner García
Diana Carolina Valencia Rua
Adriana Yelitza Isaza Marín
Carolina Rendón García
Diana Isabel García Posada

Abstract

Heterotopy of the gastric mucosa of the proximal esophagus (HMGEP) is a poorly understood and probably underdiagnosed clinical entity due to the presence of ectopic gastric mucosa islands in the proximal esophagus. Although it is usually an asymptomatic entity, it sometimes generates pharyngolaryngeal symptoms, and infrequently it can be associated with complications such as stenosis, ulcers and perforation. We present the case of a new born who manifests early with respiratory distress secondary to HMGEP, requiring orotracheal intubation and subsequent ablative laser therapy, with which the patient gradually recovers.

Article Details

Section

Reportes de Casos

How to Cite

1.
Gastric mucosa heterotopia of the proximal esophagus as a cause of respiratory distress in a newborn: case report. Acta otorrinolaringol cir cabeza cuello [Internet]. 2022 Jun. 30 [cited 2025 Dec. 31];50(2):134-8. Available from: https://mail.revista.acorl.org.co/index.php/acorl/article/view/616

References

1. Weinstock MS, Simons JP, Dohar JE. Heterotopic gastric mucosa of the proximal esophageal (HGMPE) and its potential role in pediatric dysphonia and dysphagia. Int J Pediatr Otorhinolaryngol. 2020;138:110271. doi: 10.1016/j.ijporl.2020.110271

2. Chung CS, Lin CK, Liang CC, Hsu WF, Lee TH. Intentional examination of esophagus by narrow-band imaging endoscopy increases detection rate of cervical inlet patch. Dis Esophagus.2015;28(7):666-72. doi: 10.1111/dote.12252

3. Bhatt J, Prager JD. Neonatal Stridor: Diagnosis and Management. Clin Perinatol. 2018;45(4):817-831. doi:10.1016/j.clp.2018.07.015

4. Richter GT, Thompson DM. The surgical management of laryngomalacia. Otolaryngol Clin North Am. 2008;41(5):837-64, vii. doi: 10.1016/j.otc.2008.04.011

5. Akbayir N, Alkim C, Erdem L, Sokmen HM, Sungun A, Basak T, et al. Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics. J Gastroenterol Hepatol. 2004;19(8):891-6. doi:10.1111/j.1440-1746.2004.03474.x

6. Rodríguez-Martínez A, Salazar-Quero JC, Tutau-Gómez C, Espín-Jaime B, Rubio-Murillo M, Pizarro-Martín A. Heterotopic gastric mucosa of the proximal oesophagus (inlet patch):endoscopic prevalence, histological and clinical characteristics in paediatric patients. Eur J Gastroenterol Hepatol.2014;26(10):1139-45. doi: 10.1097/MEG.0000000000000177

7. Meining A, Bajbouj M. Gastric inlet patches in the cervical esophagus: what they are, what they cause, and how they can be treated. Gastrointest Endosc. 2016;84(6):1027-1029. doi:10.1016/j.gie.2016.08.012

8. Dunn JM, Sui G, Anggiansah A, Wong T. Radiofrequency ablation of symptomatic cervical inlet patch using a throughthe- scope device: a pilot study. Gastrointest Endosc.2016;84(6):1022-1026.e2. doi: 10.1016/j.gie.2016.06.037

9. Rusu R, Ishaq S, Wong T, Dunn JM. Cervical inlet patch: new insights into diagnosis and endoscopic therapy. Frontline Gastroenterol. 2018 Jul;9(3):214-220. doi: 10.1136/flgastro-2017-100855

10. Di Nardo G, Cremon C, Bertelli L, Oliva S, De Giorgio R, Pagano N. Esophageal Inlet Patch: An Under-Recognized Cause of Symptoms in Children. J Pediatr. 2016;176:99-104.e1. doi: 10.1016/j.jpeds.2016.05.059

11. Chong VH. Clinical significance of heterotopic gastric mucosal patch of the proximal esophagus. World J Gastroenterol. 2013;19(3):331-8. doi: 10.3748/wjg.v19.i3.331

12. Jacobs E, Dehou MF. Heterotopic gastric mucosa in the upper esophagus: a prospective study of 33 cases and review of literature. Endoscopy. 1997;29(8):710-5. doi: 10.1055/s-2007-1004294

13. von Rahden BH, Stein HJ, Becker K, Liebermann-Meffert D, Siewert JR. Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopathologic classification. Am J Gastroenterol. 2004;99(3):543-51. doi: 10.1111/j.1572-0241.2004.04082.x

14. Orosey M, Amin M, Cappell MS. A 14-Year Study of 398 Esophageal Adenocarcinomas Diagnosed Among 156,256 EGDs Performed at Two Large Hospitals: An Inlet Patch Is Proposed as a Significant Risk Factor for Proximal Esophageal Adenocarcinoma. Dig Dis Sci. 2018;63(2):452-465. doi:10.1007/s10620-017-4878-2

15. Macha S, Reddy S, Rabah R, Thomas R, Tolia V. Inlet patch: heterotopic gastric mucosa--another contributor to supraesophageal symptoms? J Pediatr. 2005;147(3):379-82.doi: 10.1016/j.jpeds.2005.03.002

16. Variend S, Howat AJ. Upper oesophageal gastric heterotopia: a prospective necropsy study in children. J Clin Pathol. 1988;41(7):742-5. doi: 10.1136/jcp.41.7.742

17. Weickert U, Wolf A, Schroder C, Autschbach F, Vollmer H. Frequency, histopathological findings, and clinical significance of cervical heterotopic gastric mucosa (gastricinlet patch): a prospective study in 300 patients. Dis Esophagus. 2011;24(2):63-8. doi: 10.1111/j.1442-2050.2010.01091.x

Most read articles by the same author(s)