A Case of Heterotopic Gastric Mucosa of the Terminal Ileum Presenting Multiple Diffuse Polyps

Abstract

We report a rare case of inflammation of the terminal ileum presenting numerous diffuse pseudopolyps and erosions. The patient was a 41‐year‐old man with multiple polypoid lesions in the terminal ileum causing anemia and hypoalbuminemia, which were found incidentally during preoperative evaluation of an early gastric cancer. Ileocecal resection was performed, and histological examination revealed the presence of heterotopic gastric mucosa (HGM) with fundic‐type glands. Tuberculous colitis and non‐specific inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, were ruled out clinically and histologically, and no other primary lesions capable of causing gastric metaplasia, such as Meckel's diverticulum, were detected. We therefore concluded that the HGM in this patient was not a metaplastic response to inflammation, but rather of congenital inflammation‐inducing origin. To our knowledge, only 29 cases of HGM of the small intestine beyond the ligament of Treitz, excluding Meckel's diverticulum and other congenital anomalies of the bowel, have been reported in the literature. Furthermore, we have found no reference to cases similar to our present patient. (Dig Endosc 1996 ; 8 : 225‐230)