Esophageal inlet patch

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Esophageal inlet patch
Other names"heterotopic gastric mucosa of the upper esophagus", "gastric inlet patch"
SpecialtyGastroenterology
SymptomsGlobus sensation, sore throat, heartburn, difficulty swallowing
Diagnostic methodEsophagogastroduodenoscopy
TreatmentAblation with argon plasma coagulation or radiofrequency ablation
Frequency1 - 12%[1]

Esophageal inlet patch or heterotopic gastric mucosa of the upper esophagus or gastric inlet patch is one or more areas of tissue resembling stomach tissue which is found in the upper portion of the esophagus.

Description and etiology[edit]

Esophageal inlet patches are well defined areas of mucosa which resemble stomach tissue and are pink or salmon colored.[2] The mucosal surface of an esophageal inlet patch are typically flat,[3] but may be slightly raised or slightly depressed.[2]

The development of an esophageal inlet patch may occur due to the misplacement of endoderm from the stomach early in development.[1]

Signs and symptoms[edit]

Often esophageal inlet patches causes no symptoms and are identified incidentally during upper endoscopy.[3] However, when present, symptoms may include difficulty swallowing (dysphagia), pain while swallowing (odynophagia), cough or globus sensation.[1] Symptoms

Whether esophageal inlet patches may cause other symptoms, such as chronic cough, globus sensation, laryngitis is unclear.[1]

Occasionally, esophageal inlet patches may be seen during barium esophagram.[3] Findings may include an irregular outline or indentation suggestive of an inlet patch.[3]

Diagnosis[edit]

Esophageal inlet patches are diagnosed by upper endoscopy (esophagogastroduodenoscopy or EGD). Detection of esophageal inlet patches may be improved by the use of specialized imaging techniques such as narrow-band imaging (optical chromoendoscopy).[2]

Treatment[edit]

Often treatment for esophageal inlet patch is not necessary. However, when symptoms occur, treatment may consist of ablation.[1] Ablation may be performed with argon plasma coagulation or radiofrequency ablation.[1] When performed by an experienced physician, side effects from ablation appear to be negligible.[1]

When symptoms occur, treatment with a proton pump inhibitor may be considered.[3]

Epidemiology[edit]

The prevalence of esophageal inlet patch is between 1% and 12%.[1]

Esophageal inlet patches are associated with Helicobacter pylori infection.[3] Although reports are conflicting, some studies have found an association between esophageal inlet patches and Barrett's esophagus.[4]

References[edit]

  1. ^ a b c d e f g h Meining, A; Bajbouj, M (December 2016). "Gastric inlet patches in the cervical esophagus: what they are, what they cause, and how they can be treated". Gastrointestinal Endoscopy. 84 (6): 1027–1029. doi:10.1016/j.gie.2016.08.012. PMID 27855791.
  2. ^ a b c Ciocalteu, A; Popa, P; Ionescu, M; Gheonea, DI (14 August 2019). "Issues and controversies in esophageal inlet patch". World Journal of Gastroenterology. 25 (30): 4061–4073. doi:10.3748/wjg.v25.i30.4061. PMC 6700698. PMID 31435164.
  3. ^ a b c d e f Rusu, R; Ishaq, S; Wong, T; Dunn, JM (July 2018). "Cervical inlet patch: new insights into diagnosis and endoscopic therapy". Frontline Gastroenterology. 9 (3): 214–220. doi:10.1136/flgastro-2017-100855. PMC 6056090. PMID 30046427.
  4. ^ Chong, VH (21 January 2013). "Clinical significance of heterotopic gastric mucosal patch of the proximal esophagus". World Journal of Gastroenterology. 19 (3): 331–8. doi:10.3748/wjg.v19.i3.331. PMC 3554816. PMID 23372354.