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Heterotopic gastric mucosa (HGM) of esophagus, primarily occurring in cervical esophagus, is usually asymptomatic. A healthy woman (mid-40s) with postprandial heartburn was diagnosed with middle esophageal HGM and esophageal ulcers by esophagogastroduodenoscopy. Using 8-channel pH monitoring, a sensor near the HGM area detected postprandial acid phase (pH 3-4), while areas adjacent to the proximal and distal sensors were neutral, suggesting acid secretion from the HGM. A biopsy showed fundic gland tissue expressing H+/K+-ATPase and pepsinogen-I. Oral vonoprazan improved the clinical symptoms and endoscopic findings. This is the first report using 8-channel pH monitoring to diagnose extremely rare middle esophageal HGM.

Citation

Kenichi Kishimoto, Kotaro Shibagaki, Saya Nonomura, Shohei Sumi, Naoki Fukuda, Yusuke Takahashi, Satoshi Kotani, Eiko Okimoto, Naoki Oshima, Kousaku Kawashima, Norihisa Ishimura, Shunji Ishihara. Heterotopic Gastric Mucosa in Middle Esophagus Complicated with Esophageal Ulcers. Internal medicine (Tokyo, Japan). 2022 Feb 26;61(18):2735-2740

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PMID: 35228416

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