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Resumen Introducción: La heterotopia de mucosa gástrica, hace referencia a la localización ectópica de mucosa gástrica en cualquier parte del tracto gastrointestinal. Es una causa poco frecuente de úlceras gastrointestinales y sangrado digestivo oculto. La videocápsula endoscópica se ha convertido en una herramienta fundamental para el estudio del intestino delgado. Métodos: Estudio descriptivo de reporte de caso. La información de la historia clínica, reporte de patología y estudios endoscópicos, se extrajo desde las bases de datos de la Fundación Valle del Lili. Resultados: Paciente masculino de 71 años, en quien se realizó videocápsula endoscópica por sangrado digestivo oculto y se encontraron segmentos de estenosis y úlceras en yeyuno. La histopatología reveló la presencia de mucosa gástrica heterotópica. Conclusión: La heterotopia de mucosa gástrica debe ser pensada como causa de posible sangrado de intestino delgado.
Resumen Introducción: La heterotopia de mucosa gástrica, hace referencia a la localización ectópica de mucosa gástrica en cualquier parte del tracto gastrointestinal. Es una causa poco frecuente de úlceras gastrointestinales y sangrado digestivo oculto. La videocápsula endoscópica se ha convertido en una herramienta fundamental para el estudio del intestino delgado. Métodos: Estudio descriptivo de reporte de caso. La información de la historia clínica, reporte de patología y estudios endoscópicos, se extrajo desde las bases de datos de la Fundación Valle del Lili. Resultados: Paciente masculino de 71 años, en quien se realizó videocápsula endoscópica por sangrado digestivo oculto y se encontraron segmentos de estenosis y úlceras en yeyuno. La histopatología reveló la presencia de mucosa gástrica heterotópica. Conclusión: La heterotopia de mucosa gástrica debe ser pensada como causa de posible sangrado de intestino delgado.
A 24-year-old male reported to the gastrosurgery casualty with acute onset of abdominal pain. On general examination the patient was febrile and abdominal examination showed guarding and tenderness. Routine blood investigation reports were normal except for a mild neutrophilia. Ultrasonography of the abdomen revealed perforation peritonitis and an emergency exploratory laparotomy was performed. Peroperatively, jejunum showed multiple strictures and perforation. Jejunal resection was done and was sent for histopathological examination.Resected specimen showed jejunal segment 40 cm long with multiple strictures and serosal exudate. Mucosa at the site of strictures appeared polypoidal [Table/ Fig-1]. Histopathological examination revealed a clear transition from jejunal to gastric type epithelium in the polypoid mucosa at all stricture sites [Table/ Fig-2]. The gastric glands were predominantly of pyloric type. Ulceration of gastric type mucosa at stricture site was seen. Mucosal congestion, prominent muscularis mucosa, chronic inflammation, fibrosis and serosal exudates were also seen [Table/ Fig-3]. Intervening jejunal mucosa appeared normal except for mild mucosal congestion. Mucin histochemistry by alcian blue technique showed positive staining in jejunal mucosa and absence of staining in polypoid mucosa at stricture site confirming it to be gastric type foveolar epithelium which contains neutral mucin [Table /Fig-4 AbSTRACTGastric heterotopias beyond the ligament of Treitz though rare, should be thought of in the differential diagnosis of polypoid lesions presenting with gastrointestinal bleed or obstructive symptoms especially in children and in the young. Here is a 24-year-old male with multifocal jejunal gastric heterotopias causing multiple strictures and perforation peritonitis. Patient presented with acute abdomen pain and an emergency laparotomy was performed revealing jejunum with multiple strictures and perforation, followed by jejunal resection. On gross examination polypoid mucosa was noted at the stricture sites which showed heterotopic gastric mucosa on microscopy. Jejunal gastric heterotopias are extremely rare with less than ten reported cases and those presenting with multiple strictures are even rarer. To our knowledge this is the second case of jejunal gastric heterotopia presenting with multiple strictures.
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