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Heterotopic and metaplastic gastric mucosa in the duodenum
1Institute of Pathology, Meir General Hospital, Kfar Saba, Israel.
Israel Journal of Medical Sciences
|June 1, 1989
Summary
Metaplastic gastric epithelium (MGE) is common in duodenal mucosa, found in 30% of normal cases and 80% of duodenal ulcers. Its higher prevalence in Jewish patients suggests a potential genetic link.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Gastric epithelium can be present throughout the gastrointestinal tract.
- Congenital heterotopic gastric mucosa or acquired metaplastic gastric surface epithelium (MGE) may occur in the duodenal mucosa.
Purpose of the Study:
- To investigate the prevalence of metaplastic gastric surface epithelium (MGE) in duodenal biopsies.
- To determine the association between MGE and duodenal conditions like normal mucosa, duodenitis, and duodenal ulcers.
- To explore potential demographic or genetic factors influencing MGE prevalence.
Main Methods:
- Retrospective review of 325 duodenal biopsies from 297 patients.
- Biopsies were obtained via upper gastrointestinal endoscopy (260) and abdominal surgery (65).
- Histopathological analysis to identify normal duodenal mucosa, duodenitis, duodenal ulcer, and MGE.
Main Results:
- MGE was found in 31% of normal mucosa, 21.7% of duodenitis, and 82% of duodenal ulcer cases (P < 0.01).
- MGE was present in 120 biopsies from 109 patients (68 men, 41 women), predominantly Jewish (91%).
- Duodenal ulcers were more common in Arabs (69%) than Jews (41%), while MGE was more frequent in Jews.
Conclusions:
- Metaplastic gastric surface epithelium (MGE) is a common finding in duodenal biopsies, occurring even with normal mucosa.
- MGE is highly prevalent in cases of duodenal ulcer.
- The increased frequency of MGE in the Jewish population suggests a possible genetic predisposition.