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New Presentation of Inlet Patch with Polypoid Kissing Pattern: Case Report.
Kamyar Nikbakhsh1, Ahmadreza Mojaddad1, Avad Shokri Shirvani2
1Student Committee Research, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, I.R. Iran.
Middle East Journal of Digestive Diseases
|August 7, 2023
Summary
A rare "kissing" pattern of an esophageal inlet patch, a form of heterotopic gastric mucosa, was observed during an endoscopy for indigestion. This finding highlights the importance of examining the proximal esophagus for such conditions.
Area of Science:
- Gastroenterology
- Pathology
- Endoscopy
Background:
- Esophageal inlet patches are congenital anomalies characterized by heterotopic gastric mucosa in the proximal esophagus.
- While typically asymptomatic, they can occasionally be associated with symptoms like dysphagia or reflux.
- The 'kissing pattern' of an inlet patch, where two patches are oppositely positioned, is exceptionally rare in medical literature.
Observation:
- A 69-year-old female presented with indigestion, leading to an upper gastrointestinal endoscopy.
- The endoscopy revealed two polyps situated within a maroon patch below the upper esophageal sphincter.
- The patch exhibited an unusual 'kissing pattern,' with the lesions positioned opposite each other.
Findings:
- Histological evaluation of the polyps confirmed the presence of heterotopic cardiac gastric mucosa.
- The inlet patch extended into the muscularis mucosa and involved regional lymph nodes, which is an atypical presentation.
- No other significant pathological findings were noted in the examined biopsy.
Implications:
- This case represents the second documented instance of a kissing pattern inlet patch, emphasizing its rarity.
- The findings underscore that heterotopic gastric mucosa can occur throughout the gastrointestinal tract, necessitating thorough examination.
- Increased vigilance during endoscopic evaluation of the proximal esophagus may improve the detection rates of inlet patches and their associated findings.
