Heterotopic gastric mucosa in the proximal esophagus: historical aspect and modern view
According to the autopsy data, heterotopic gastric mucosa in the proximal esophagus (or inlet patch), which is an area of ectopic mucosa (characteristic of the stomach), is diagnosed more commonly than it is visualized endoscopically, and also is accompanied by clinical symptoms. The article is devoted to the etiology and pathogenesis of the inlet patch, as well as to the analysis concerning the prevalence of pathology and clinical manifestations. The article also presents modern clinical and pathological classification, which includes five individual groups based on the clinical, endoscopic and histological characteristics of the inlet patch. The literature data on the association of inlet patch in the upper esophagus with functional disorders of the gastrointestinal tract (GIT), Barrett’s esophagus, as well as its neoplastic transformation are considered. Special attention is paid to the diagnosis of the inlet patch based on a targeted examination of the cervical esophagus using modern endoscopic equipment. The article presents the principles of drug therapy and endoscopic treatment of symptomatic patients with the inlet patch. The review demonstrates the importance of clinicians’ awareness of this pathology and a multidisciplinary approach to patient management.