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Inlet patch: prevalence, histologic type, and association with esophagitis, Barrett esophagus, and antritis
Ping Tang1, Matthew J McKinley, Maria Sporrer
1Department of Pathology, North Shore University Hospital, Manhasset, NY 11030, USA.
Archives of Pathology & Laboratory Medicine
|March 27, 2004
Summary
Inlet patch, a congenital cervical esophagus anomaly, occurs in about 1% of patients. Oxyntic mucosa is the most common type, and H. pylori infection in the inlet patch correlates with antral infection.
Area of Science:
- Gastroenterology
- Pathology
- Endoscopy
Background:
- Inlet patch is a congenital anomaly in the cervical esophagus characterized by gastric mucosa.
- Histologic types and associated complications of inlet patch have been previously documented.
Purpose of the Study:
- Determine the prevalence and histologic types of inlet patch.
- Investigate the association of inlet patch with Barrett esophagus and Helicobacter pylori-associated gastritis.
Main Methods:
- Retrospective review of 1821 upper gastrointestinal endoscopy pathology reports (1995-2002).
- Identification and analysis of 20 patients with inlet patch, examining biopsies from cervical esophagus, distal esophagus, and antrum.
- Histologic staining (hematoxylin-eosin, Steiner stain) and gastrin-producing cell staining.
Main Results:
- Inlet patch prevalence was 1.1% in the study population.
- Oxyntic mucosa was the most common histologic type (55%) in inlet patches.
- Inflammation was observed in 60% of inlet patches; 5% were H. pylori-positive, correlating with antral H. pylori.
- Barrett esophagus was found in 20% of patients with inlet patch.
Conclusions:
- Inlet patch affects approximately 1% of patients, with oxyntic mucosa being the predominant histologic type.
- H. pylori infection in the inlet patch mirrors antral infection.
- A significant association exists between inlet patch and esophagitis (25%) and Barrett esophagus (20%).