Abstract
Heterotopic gastric mucosa (HGM) is gastric mucosal tissue outside the stomach. It can be discovered anywhere throughout the gastrointestinal tract and is mostly asymptomatic. HGM, although rare beyond the ligament of Treitz, should be included in the differential diagnosis in a young patient with a polyp causing obstructive symptoms or bleeding. Very few cases are published in literature. We describe a case of young male who presented with an episode of large amount of melena, from a bleeding jejunal lesion, diagnosed by endoscopy. Laparotomy and wedge resection of the jejunal lesion was done, and histopathology showed gastric heterotopia in a small jejunal diverticulum.
Highlights
Heterotopia (Greek origin), literally meaning different location, is the presence of a tissue type normally found in the human body but in an abnormal location [1] and can occur throughout the gastrointestinal tract
Gastric heterotopia is an uncommon condition, and it is important to differentiate it from metaplasia
Biliary ducts and gallbladder, umbilicus and respiratory tract, bronchogenic and thyroglossal cysts, the spinal column, intraabdominal and intrathoracic locations, the urinary bladder, and scrotum are other unusual sites reported for the presence of Heterotopic gastric mucosa (HGM) [7]
Summary
Heterotopia (Greek origin), literally meaning different location, is the presence of a tissue type normally found in the human body but in an abnormal location [1] and can occur throughout the gastrointestinal tract. The patient denied any fever, headache, chest pain, shortness of breath and palpitations, or cardiac diseases On examination, his pulse was 75 beats per minute, blood pressure 125/78, JVP was not raised, S1 and S2 were normal, and no added sounds on the chest examination. In the course of time, the patient developed tachycardia of 122 bpm but blood pressure remained normal. Colonoscopy was normal, whereas enteroscopy showed a jejunal diverticulum about 50 cms from the pylorus with fresh bleeding (Figure 1). The specimen consists of a false diverticulum of the small bowel (jejunum) showing a focal, cystically dilated gland within the muscularis propria which, on deeper sections, showed gastric-type mucosal tissue. The mucosa was unremarkable, and the specimen was negative for dysplasia and malignancy (Figures 2 and 3)
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