Heterotopic gastric mucosa (inlet patch) in a patient with laryngopharyngeal reflux (LPR) and laryngeal carcinoma: a case report and review of literature

Basseri, Benjamin; Conklin, Jeffrey L.; Mertens, Richard B.; Lo, Simon K.; Bellack, G. S.; Shaye, Omid

doi:10.1111/j.1442-2050.2008.00915.x

Cited by 26 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most “inlet patches” are clinically asymptomatic; only in 10% of cases do they produce clinical symptoms, such as chest and throat pain, dysphagia, globus sensation, shortness of breath, chronic cough and hoarseness [1, 16, 21, 22]. In our study only 2 of 20 patients reported clinical symptoms related to HGMUE.…”

Section: Discussionmentioning

confidence: 55%

Clinical evaluation of twenty cases of heterotopic gastric mucosa of upper esophagus during five-year observation, using gastroscopy in combination with histopathological and microbiological analysis of biopsies

Latos¹,

Sieroń–Stołtny²,

Kawczyk‐Krupka³

et al. 2013

View full text Add to dashboard Cite

Aim of the studyHeterotopic gastric mucosa of the upper esophagus (HGMUE) may be connected with disorders of the upper gastrointestinal tract, exacerbated by Helicobacter pylori. Furthermore, HGMUE may be the origin of malignant progression to cervical esophageal carcinoma.Material and methodsIn this work, 20 patients with diagnosed heterotopic gastric mucosa of the upper esophagus (HGMUE) were subjected to 5-year follow-up to determine the extent and structure of histopathological changes within HGMUEs, as well as HGMUE dysplasia and metaplasia, and risk of their malignant transformation. As a diagnostic tool to describe localization, form, size and surface feature of HGMUEs, endoscopy was used. At the same time, the biopsies were collected for histopathological and microbiological analysis.ResultsIn examined patients, HGMUEs were associated with inflammation, chronic gastritis, hiatus hernia, duodenal bulb erosion and ulcer and infection of H. pylori. Intestinal metaplasia and low grade dysplasia were also indicated. During 5 years of observation, both the clinical and histopathological image of diagnosed HGMUEs was stable. The patients with detected presence of H. pylori were treated with triple or quadruple therapy.These results show that HGMUEs may be associated with severe complications in the gastrointestinal tract, such as infection by H. pylori, hiatus hernia or duodenal ulcer. Although dysplasias and metaplasias found in diagnosed HGMUEs were not very numerous and relatively stable both clinically and histopathologically, at the present stage of the study we cannot exclude the possibility of HGMUE malignant transformation.

show abstract

Section: Discussionmentioning

confidence: 55%

Clinical evaluation of twenty cases of heterotopic gastric mucosa of upper esophagus during five-year observation, using gastroscopy in combination with histopathological and microbiological analysis of biopsies

Latos¹,

Sieroń–Stołtny²,

Kawczyk‐Krupka³

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Most inlet patches are largely asymptomatic, but in problematic cases complications related to acid secretion such as esophagitis, ulcer, web, and stricture may produce symptoms such as chest and throat pain, dysphagia, globus sensation, and shortness of breath [6–8]. The size of the patch is related with dysphagia severity, possibly as a function of increased acid secretion [9].…”

Section: Discussionmentioning

confidence: 99%

Esophageal Inlet Patch

Behrens

Yen

2011

Radiology Research and Practice

View full text Add to dashboard Cite

An inlet patch is a congenital anomaly consisting of ectopic gastric mucosa at or just distal to the upper esophageal sphincter. Most inlet patches are largely asymptomatic, but in problematic cases complications related to acid secretion such as esophagitis, ulcer, web and stricture may occur. The diagnosis of inlet patch is strongly suggested on barium swallow where the most common pattern consists of two small indentations on the wall of the esophagus. The diagnosis of inlet patch is confirmed via endoscopy with biopsy. At endoscopy, the lesion appears salmon-coloured and velvety and is easily distinguished from the normal grey-white squamous epithelium of the esophagus. The prominent margins correlate with the radiological findings of indentations and rim-like shadows on barium swallow. Histopathology provides the definitive diagnosis by demonstrating gastric mucosa adjacent to normal esophageal mucosa. No treatment is required for asymptomatic inlet patches. Symptomatic cases are treated with proton pump inhibitors to relieve symptoms related to acid secretion. Strictures and webs are treated with serial dilatation and should be biopsied to rule out malignancy.

show abstract

“…Reflex evokes a vagally mediated change, resulting in clinical symptoms, including chronic cough and asthma-like symptoms though bronchoconstriction. A decrease in the resting tone of the upper and lower esophageal sphincters and increases in intraabdominal pressure are also associated with the refluxate bolus and subsequent occurrence of LPR [11,[28][29][30][31][32][33][34][35].…”

Section: Etiopathogenesis Of Lprmentioning

confidence: 99%

Laryngopharyngeal Reflux: An Update

Kuo¹

2019

AOHNS

View full text Add to dashboard Cite

Laryngopharyngeal reflux (LPR), also referred to as extra-esophageal reflux, supra-esophageal reflux, or silent reflux, refers to a condition in which gastroduodenal content rises up the esophagus and affects the throat, specifically the laryngopharynx [1-6]. In some cases, gastric content may even reach the nasal cavities and/or ears via the Eustachian tubes, which can exacerbate rhinitis, sinusitis, or otitis media [7-9]. Otolaryngologists and gastroenterologists differ in their definitions and management of LPR [4,10-12]. Otolaryngologists treat LPR as a relatively new clinical entity, whereas gastroenterologists treat LPR as a rare extra-esophageal manifestation of gastroesophageal reflux disease (GERD) [10,13]. Gastroenterologists have questioned whether reflux contributes to LPR-related symptoms in patients with no GERD-associated manifestations [11]. Otolaryngologists have pointed out that LPR is a multifactorial syndrome that also involves gaseous and/or nonacid refluxate [14,15]. In this article, we examine the clinical manifestations, diagnosis, and current recommended treatments of LPR. Based on the latest findings in LPR research, we propose an algorithm aimed at facilitating the assessment and management of LPR. Differences Between LPR and GERD Despite similarities between LPR and GERD, these are two distinct disease entities. The retrograde flow of gastroduodenal contents into the esophagus and/or adjacent structures can lead to complications or troublesome reflux-associated symptoms, such as throat clearing, heartburn, and globus pharyngeus. Reflux diseases can be categorized as LPR, erosive esophagitis, and nonerosive reflux disease (NERD). Cases of erosive esophagitis and NERD are categorized as GERD [16]. In GERD, the reflux of gastric contents is limited to the esophagus. In LPR, the reflux of gastric content affects the larynx and pharynx [12]. Despite occasional cross-diagnoses of GERD and LPR, there are essential differences (Table 1). GERD is accompanied by acidity and heartburn (retrosternal burning), which is rarely encountered in LPR patients [12]. In GERD, reflux and acidity typically occur during the night (nocturnal refluxers). In LPR, reflux typically occurs during the day (daytime refluxers) [12]. LPR symptoms occur when patients are in an upright position during periods of physical exertion (e.g., bending over, Valsalva, and exercise) [11,12,17], whereas GERD reflux occurs while patients are lying down.

show abstract

Heterotopic gastric mucosa (inlet patch) in a patient with laryngopharyngeal reflux (LPR) and laryngeal carcinoma: a case report and review of literature

Cited by 26 publications

References 28 publications

Clinical evaluation of twenty cases of heterotopic gastric mucosa of upper esophagus during five-year observation, using gastroscopy in combination with histopathological and microbiological analysis of biopsies

Clinical evaluation of twenty cases of heterotopic gastric mucosa of upper esophagus during five-year observation, using gastroscopy in combination with histopathological and microbiological analysis of biopsies

Esophageal Inlet Patch

Laryngopharyngeal Reflux: An Update

Contact Info

Product

Resources

About