Pediatric Heterotopic Gastric Mucosa of the Cervical Esophagus (Inlet Patch): Case Series with Clinical, Endoscopic, and Histopathological Correlation
<b>Introduction:</b> Inlet patch (IP) is a congenital anomaly characterized by gastric heterotopia in the cervical esophagus. While extensively described in adults, it remains poorl characterized in pediatric populations. <b>Material and Methods:</b> This retrospective, singl...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-06-01
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| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/12/6/752 |
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| Summary: | <b>Introduction:</b> Inlet patch (IP) is a congenital anomaly characterized by gastric heterotopia in the cervical esophagus. While extensively described in adults, it remains poorl characterized in pediatric populations. <b>Material and Methods:</b> This retrospective, single-center study included all pediatric patients (0–14 years) diagnosed with IP between 2018 and 2025. Sociodemographic and clinical data were collected. A blinded pathologist assessed the presence and severity of inflammation within the IP. <b>Results:</b> Nine patients (median age, 12 years; range, 6–14 years) were included, with 78% beingmale. Cervical esophageal symptoms were identified in 67%, primarily dysphagia and gastroesophageal reflux disease-related complaints, although concomitant conditions such as eosinophilic esophagitis were frequently present. Three patients had symptoms potentially attributable to IP (33%). Endoscopic examination revealed characteristic well-demarcated salmon-red plaques in all patients, with multiple lesions observed in three cases. Histology confirmed gastric heterotopia with varying degrees of chronic inflammation in all cases. A potential association was observed between the severity of gastritis in the stomach, the severity of inflammation in the IP, and the presence of <i>H. pylori</i>, with 75% of patients with moderate-to-severe IP inflammation also exhibiting gastric <i>H. pylori</i>-associated gastritis. All patients except one received proton pump inhibitors, and symptoms improved in all cases. <b>Conclusions:</b> A thorough and targeted examination of the cervical esophagus significantly increased IP detection at our center, with most cases (89%) being diagnosed in the last 12 months. While mostly asymptomatic and incidental, IP can be symptomatic. In this case, series, we found a possible association between the severity of inflammation in the IP, the severity of gastritis, and the presence of <i>H. pylori</i>. Further studies are needed to define the clinical significance of pediatric IP and optimal management. |
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| ISSN: | 2227-9067 |