Çocuklarda Inlet Patch’in Klinik Önemi

Abstract

Inlet patch (IP) is an area of heterotopic gastric mucosa located in proximal esophagus. Although the majority of IP are asymptomatic, they may be associated with digestive and respiratory symptoms. We aimed to assess prevalence, endoscopic and histopathological findings, clinical significance and outcome of inlet patch in children.The patients with histopathologically proven IP and aged between 0-18 years old were enrolled. Demographic data, clinical symptoms, endoscopic and histopathological findings, treatment modality, and outcomes were collected from medical records. Retrospective review of 2674 esophagogastroduodenoscopy records revealed 11 (0.41%) children. Eight of our patients had a solitary patch whereas others had two (n=1) or three (n=2). Histopathological evaluation revealed that 9 patients had fundic and 2 patients had antral type gastric mucosa. One patient with hematemesis and other with dysphagia had hyperemic patchy areas of which were colonized by H. pylori. Inlet patch was the only pathological endoscopic finding in 4 patients with a single symptom each: heartburn, dysphagia, hematemesis and hoarseness. Symptoms were completely resolved with PPI treatment in 8 children. Helicobacter pylori eradication was achieved in all infected patients. No respiratory symptom was recorded except hoarseness in one patient. No complications like perforation, stenosis or dysplasia that might be related to IP were recorded at follow-up. We suggest that an IP may accompany or may be responsible for digestive symptoms in children and PPI treatment is effective. Endoscopist should be aware of this condition, especially if the patient has dyspeptic symptoms and normal endoscopic findings.