Heterotopic Gastric Mucosa in the Duodenum

Abstract

Islets of fully developed gastric mucosa i.e. containing parietal cells and sometimes pepsinogen cells were found in the duodenal cuff in 52 outof 158 gastric resection specimens. The gastric mucosa was seen significantly more often in the duodenum when the gastric resection was performed for duodenal ulceration. It is thought that the high acidity associatedwith the duodenal ulceration might be the cause forthe development of the heterotopic gastric mucosa.

Serum group I pepsinogen levels in patients with peptic ulcer and normal subjects.

“…PG I has been found in urine of the patients with total gastrectomy and this finding suggests that PG I is produced in the alimentary tract other than the stomach (Mangla and Kim 1974;Ishimori et al 1976). We have found by radioimmunoassay small but sufficient amounts of serum PG I in the sera of the totally gastrectomized patients and confirmed the extra-gastric sources of PG I. Heterotopic fundic gland mucosa in the duodenum is considered to be a most likely candidate for the extra-gastric sources of PG I (Hoedemacker 1970;Johansen and Hansen 1973). Samloff et al (1975b) reported that there was a positive correlation between serum PG I level and PAO, and suggested that the level of serum PG I may be determined by the chief cell mass.…”

Signet-Ring Cell Carcinoma of the Ampulla of Vater: Report of a Case

“…8,15 Another theory suggests that these carcinomas arise from areas of gastric-type metaplastic epithelia, which are considered to be a protective response to elevated acidity and are observable in the duodenal bulb of peptic ulcer patients. 29 In this theory, signet-ring cells may originate from periampullary duodenal heterotopia of an ulcer etiology and expand secondarily to the ampulla of Vater. In the present case, however, no ectopic gastric epithelium was found in the peritumoral lesion, and the patient also had no history of peptic ulcer disease.…”

Gastric foveolar metaplasia and gastric heterotopia in the duodenum: no evidence of an etiologic role for Helicobacter pylori

“…Although there are case reports of patients in whom significant portions of the small intestine were replaced by gastric tissue [1,2] and of large polypoid masses composed of heterotopic gastric tissue [3,4], in most patients, these are believed to be small lesions with the appearance of diminutive polyps, elevated patches, or flat erythematous areas [5,6]. In many instances, they are incidental histopathologic findings in duodenal specimens submitted for the evaluation of unrelated conditions.…”

“…In many instances, they are incidental histopathologic findings in duodenal specimens submitted for the evaluation of unrelated conditions. Information regarding gastric heterotopia in the duodenum is derived from individual case reports or relatively small studies, mostly carried out several decades ago [5][6][7][8]; therefore, the nature of this lesion remains largely unknown. There are no recent data regarding its clinical significance, its associations with other conditions, and its histopathologic and functional characteristics.…”