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Inlet patch: clinical presentation and outcome in children

Amandine Georges1, Stéphanie Coopman, Julie Rebeuh

  • 1Department of Pediatric Gastroenterology, and Reference Center for Congenital and Malformative Esophageal Diseases, Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France.

Journal of Pediatric Gastroenterology and Nutrition
|January 18, 2011
PubMed

Insights

Inlet patch (IP), a type of heterotopic gastric mucosa in the esophagus, is uncommon in children but can cause digestive and respiratory symptoms. Further recognition is needed for better diagnosis and management.

Area of Science:

  • Pediatric Gastroenterology
  • Esophageal Pathology
  • Gastrointestinal Endoscopy

Background:

  • Inlet patch (IP) is defined as heterotopic gastric mucosa in the proximal esophagus.
  • Information regarding IP in pediatric populations is limited.
  • This study investigates the clinical significance, characteristics, and natural history of IP in children.

Purpose of the Study:

  • To assess the clinical significance of inlet patch in children.
  • To describe the endoscopic and histological characteristics of pediatric IP.
  • To evaluate the natural history and treatment outcomes of IP in children.

Main Methods:

  • Retrospective multicenter study involving 7 French pediatric gastrointestinal centers.
  • Data collected included demographics, clinical symptoms, endoscopic findings, histology, treatment, and follow-up.
  • Fifteen children diagnosed with IP were included in the analysis.

Main Results:

  • The median age at diagnosis was 9.5 years; 5 children had esophageal atresia and 9 had gastroesophageal reflux.
  • Digestive symptoms (dysphagia, food impaction) were present in 14 patients; 6 had respiratory/ENT symptoms.
  • Endoscopic findings showed a salmon-pink lesion in the proximal esophagus; H. pylori was found in 2 patients. Symptom improvement was noted in 8/13 patients on PPI treatment.

Conclusions:

  • Inlet patch is an underrecognized esophageal lesion in children.
  • IP can be associated with significant digestive and respiratory symptoms.
  • Early diagnosis and appropriate management may improve outcomes for children with IP.
Abstract

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