The case of an elderly man with hete rotopic gastric mucosa of the ce rvical esophagus associated with an esophageal we b, as well as a d iscussion ofhete rotopic gastric mucosa, arc presented. T he presen ce of an ' inle t patch ' is a commo n e ndoscopic fi nd ing; about 10% of the population will have the hc tc ro to pic mucosa just below the upper esophagea l sphincter. Although th ere is controversy regardi ng pathogenesis, a congenital origin is fa voured over an acquired lesio n, The parc hes may be single, multiple or c irc umferentia l. His to logically, just over ha lf a rc ectopic gastric fu ndic mucosa a nd 90% of the pa tc hes conta in both parie ta l a nd c hief cells. Most patients with the inlet patch rema in asympto matic; about 15% w ith have mild pharyngeal d isco mfort and/or high dysphagia. Sympto ms will often accompa ny the deve lo pme nt of a comp lication, such as ulceration , that may be associated with bleeding, a stricture at the squamocolumnar junctio n o r an esophageal web. D iagnost ic manoeu vres to identify the mucosa include barium stud ies, endoscopy, Congo red sra ining to visua lize ac id production and nuclear medic ine scans. N o treatmen t is necessary unl ess complications develop. Compl ications can be treated successfu lly with H z blocke rs and/or e ndoscopic dilation. N o fo llow-up appears to be necessary as the re is no proof fo r malignan t transformation of the ecto pic mucosa.
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