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Heterotopic gastric mucosa involving the gallbladder and biliary tree
Carmen Madrid1, Teresa Berrocal, Luis Gorospe
1Department of Paediatric Radiology, Hospital Infantil "La Paz", Paseo de la Castellana 261, 28046 Madrid, Spain. cprieto@hulp.insalud.es
Insights
This case report details heterotopic gastric mucosa found in a child's biliary system. This extremely rare condition required surgical intervention and highlights unique imaging findings.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Medical Imaging
Background:
- Heterotopic gastric mucosa, the presence of gastric tissue outside the stomach, is rare in the biliary tree.
- While found throughout the gastrointestinal tract, its occurrence in the gallbladder and bile ducts is exceptionally uncommon.
Observation:
- A 3-year-old girl presented with abdominal pain and jaundice, indicative of biliary obstruction.
- Abdominal ultrasound (US) and computed tomography (CT) revealed biliary tree dilatation and a mass in the common bile duct.
- The gallbladder appeared contracted on both US and CT examinations.
Findings:
- The mass in the common bile duct caused significant lumen narrowing.
- Histological examination confirmed the presence of fundal mucosa with parietal and chief cells, establishing the diagnosis of gastric heterotopia.
- This represents the fifth reported case of heterotopic gastric tissue in the common bile duct and the first detailing US and CT findings.
Implications:
- Surgical resection of the affected common bile duct and gallbladder, followed by choledochojejunostomy, was performed.
- This case underscores the importance of considering rare diagnoses in pediatric hepatobiliary conditions.
- The study contributes novel radiological insights into heterotopic gastric mucosa in the biliary tree, aiding future diagnoses.
Abstract:
A case of heterotopic gastric mucosa in the common bile duct, cystic duct and gallbladder is reported in a 3-year-old girl with abdominal pain and jaundice. Abdominal US and CT showed dilatation of the biliary tree and a well-defined mass in the common bile duct that narrowed its lumen. The gallbladder was contracted in both examinations. The common bile duct and the gallbladder were resected and a choledochojejunostomy was performed. Although gastric heterotopy has been described throughout the entire length of the gastrointestinal tract, it is a very uncommon finding in the gallbladder and extremely rare in the biliary tree. A firm diagnosis of gastric heterotopia is based on the presence of fundal mucosa replete with parietal and chief cells. To our knowledge, this is the fifth reported case of heterotopic gastric tissue within the common bile duct, and the first to describe the US and CT findings. A relevant literature review and brief outline of the histological and radiological features are included in the discussion.