Özofageal inlet patch: Hastaların demografik ve endoskopik karakteristikleri ve litaratürün gözden geçirilmesi

Giriş ve Amaç: Özofageal inlet patch yutkunma zorluğunda, laringofarengeal reflü semptomlarında ve nadir de olsa proksimal özofagus adenokarsinom etiyolojisinde önemlidir. Amacımız endoskopik değerlendirme sırasında özofageal inlet patch tespit ettiğimiz hastaların endoskopik ve demografik özelliklerini değerlendirmek ve literatürle karşılaştırmaktı. Gereç ve Yöntem: Ocak 2017-Ocak 2021 tarihleri arasında üst gastrointestinal endoskopik değerlendirmede özofagusta inlet patch saptanan hastaların yaş, cinsiyet, inlet patch boyutları ve sayısı ile hastalarda saptanan diğer endoskopik bulguları değerlendirdik. Bulgular: Toplam 53 hastanın 36’sı (%68) kadındı. Yaş ortalaması 46.3 ± 15.8, değer aralığı (19-83) yıldı. Hastaların 13’ü inlet patch tanısı açısından semptomatikti. Özofageal inlet patch median boyutları kadınlarda 7.0 mm, değer aralığı (4-30) iken; erkeklerde 8 mm, değer aralığını (5-20) saptadık. Her iki cinsiyette median inlet patch sayısı 1, değer aralığı kadınlarda 1-3, erkeklerde 1-2 idi. Hastaların 29’unda (%54.7) forseps biyopsisi yapılabildi. Hastaların 45’inde (%84.9) ilave özofagus patolojisi saptamadık, 39’unda (%73.5) alt özofagus sfinkteri normal, 14’ünde (%26.4) incompetant, 1 (%1.8) hastada ise Hiatal Herni saptadık. 29 (%55.7) hastada endoskopik antral gastrit bulgusu saptadık. 22 endoskopik biyopsinin 12’sinde (%54.5) Helicobacter pylori pozitifti. Ayrıca 2 (%3.7) hastada özofageal inlet patch distal özofagus yerleşimli olarak tespit edildi. Sonuç: Özofageal inlet patch kadınlarda daha sıktı, gastroözofageal reflü hastalığı ile ilişkisizdi ve çoğu hasta asemptomatikti. Özofageal inlet patch’lerin median boyutları 8 mm, değer aralığı (4-30) idi, kadın erkek arasında fark saptamadık. İnlet patch boyutları ile semptom varlığı arasında da ilişki kuramadık. Biyopsi alınan inlet patchlerin hiçbirisinde malignite bulgusuna rastlamadık.

Anahtar Kelimeler:

Endoskopi, inlet patch, heterotopik gastrik mukoza

Esophageal inlet patch: Demographic and endoscopic characteristics of patients and review of the literature

Background and Aims: An esophageal inlet patch is crucial in swallowing difficulty, laryngopharyngeal reflux symptoms, and rarely in the etiology of proximal esophagus adenocarcinoma. We aimed to evaluate the endoscopic and demographic features of patients with esophageal inlet patch during endoscopic evaluation and compare them with those of the literature. Material and Method: Between January 2017 and January 2021, we evaluated the age, gender ratio, inlet patch size, and number along with the other endoscopic findings in patients with proximal esophageal inlet patch. Results: Overall, 53 patients (women, 36 (68%); mean age, 46.3 ± 15.8 years; range, 19–83 years) were included the study. Only 13 patients (24.5%) had specific symptoms of esophageal inlet patch. The median esophageal inlet patch size was 7.0 mm in women (range, 4–30), while it was 8 mm (range, 5–20) in men. The median inlet patch number was 1 in both sexes (range, 1–3 in women, 1–2 in men). Forceps biopsy was possible in 30 (56.6%) patients. We found no additional esophageal pathology in 45 (84.9%) patients, normal lower esophageal sphincter in 39 (73.5%), incompetent lower esophageal sphincter in 14 (26.4%), hiatal diaphragmatic hernia in 1 (1.8%), and endoscopic antral gastritis in 29 (55.7%) patients. Twelve (54.5%) of 22 endoscopic biopsies were positive for Helicobacter pylori. We detected esophageal inlet patch in the distal esophagus in 2 (3.7%) patients. Conclusion: Esophageal inlet patch was more common in women, unrelated to gastroesophageal reflux disease, and most patients were asymptomatic, with a median size of 8 mm (range, 4–30), with no gender difference. Moreover, inlet patch size was not associated with presence of symptoms. Evidence of malignancy in the biopsied inlet patches was not observed.

Keywords:

Endoscopy, inlet patch, heterotopic gastric mucosa,

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