Abdominal scanning with technetium-99m pertechnetate localizes ectopic gastric mucosa in the jejunum: case reports and review of the literature

Abstract

A 16-year-old male patient was admitted to hospital because of a fainting episode which was accompanied by diarrhoea that was dark red. All investigations were normal except a low haematocrit, a technetium-99m pertechnetate abdominal scan, which showed a large area of moderate activity in the upper left abdomen, and digital subtraction angiography, which showed bleeding in the same area where the abnormal finding on the pertechnetate scan was found. Ectopic gastric mucosa and a deep ulcer in an otherwise normal jejunum were found during the urgent exploratory laparotomy.

Recurrent gastrointestinal tract bleeding secondary to jejunal gastric heterotopia

“…Other reported symptoms associated with lesions in the small intestine include palpable abdominal mass, persistent nausea, dyspepsia, small bowel perforation, obstruction, and intussusception [1,2,[6][7][8]. Our case is unique in that the ectopic gastric mucosa recurred distally and caused recurrent ulceration after initial resection.…”

Recurrent Intussusception and Gastrointestinal Bleeding Secondary to Gastric Heterotopia of the Small Intestine

“…The first case of HGM in the small intestine without congenital abnormalities was reported in 1912 by Poindecker (8). From 1980 onward, 19 pediatric cases with small intestinal HGM without associated morphological abnormalities have been reported in the literature (1,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The patients' ages ranged from 2.5 months to 17 years; there were 15 male and 4 female patients.…”

Common characteristics of jejunal heterotopic gastric tissue in children: a case report with review of the literature

“…We did a careful review of jejunal HGM cases reported in the medical literature and noticed that jejunal HGM has characteristics in children (Tables 1 and 2) [7,8,[10][11][12][13][14][15][16][17][18][19][20][21]. We encountered 14 children presenting with congenital HGM located in the jejunum.…”

“…Congenital HGM may be patchy as occurs in inlet lesions of the esophagus, Meckel's diverticulum, and intestinal duplications or as nodular masses as encountered in the duodenum. However, congenital isolated HGM distal to the ligament of Treitz is very rare and usually presents with a single polypoid mass as noted in the present case [7,8,[10][11][12][13][14][15][16][17][18][19][20][21].…”

“…The differential diagnosis of polypoid lesions of the jejunum include hamartomatous polyp of Peutz-Jeghers syndrome, adenomas, angioma, lipoma, or carcinoid and malignant tumors such as lymphoma or carcinoma [13,17]. Nuclear imaging with technetium 99m pertechnetate has also been used to diagnosis and determined the dissemination of the lesion [14,15]. Scintigraphy is usually used in selected cases with lower GI bleeding.…”