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Heterotopic Gastric Mucosa Causing Rectal Bleeding in a Young Child

Blake Patricia-Rae Meyer1, Johnny Nguyen2, Michael Wilsey3

  • 1Florida State University College of Medicine, Tallahassee, FL.

JPGN Reports
|May 11, 2023
PubMed

Insights

Heterotopic gastric mucosa (HGM) is rare in the rectum. This case highlights HGM in a child with eosinophilic esophagitis, presenting with rectal bleeding potentially linked to PPI treatment.

Area of Science:

  • Gastroenterology
  • Pediatric Gastroenterology
  • Pathology

Background:

  • Heterotopic gastric mucosa (HGM) in the gastrointestinal tract is uncommon.
  • Eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) share some epidemiological links in pediatric populations.

Observation:

  • An 8-year-old child with a history of EoE underwent colonoscopy for suspected IBD, revealing rectal erythema and edema.
  • The child experienced intermittent rectal bleeding, initially attributed to constipation.
  • Rectal bleeding improved with proton pump inhibitor (PPI) therapy for EoE but recurred upon cessation.

Findings:

  • Histological examination confirmed heterotopic gastric mucosa (HGM) in the rectum.
  • The case suggests a potential, albeit unusual, association between HGM, EoE, and PPI response in pediatric rectal bleeding.

Implications:

  • This case underscores the importance of considering rare diagnoses like HGM in pediatric patients with unexplained gastrointestinal symptoms.
  • Further research into the incidence and management of HGM, particularly in children with related esophageal conditions, is warranted.
  • The observed response to PPI therapy warrants further investigation regarding its role in managing symptoms associated with rectal HGM.

Keywords:
eosinophilic esophagitishematocheziaheterotopic gastric mucosa

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