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- W2913050002 abstract "Introduction: Gastric mucosal prolapse (GMP) is a dynamic anatomical condition with movement of gastric mucosa into the distal esophagus. The reported incidence of GMP is between 2-5.5%. Individuals with gastric mucosal prolapse can present with hematemesis, retching, vomiting, abdominal pain or dysphagia. We here describe one such case of a 31-year-old obese woman with dyspepsia unresponsive to medical therapy and was found to have a gastric mucosal prolapse into the esophagus. Case report: A 31-year-old obese woman with medical history of bronchial asthma presented to gastroenterology clinic with persistent epigastric abdominal pain refractory to proton pump inhibitor (PPI) therapy. She described the pain to be burning in nature and exacerbated at night when lying down. She also reported nausea and nonproductive cough. Physical examination was remarkable only for obesity and mild epigastric tenderness. Esophagogastroduodenoscopy (EGD) demonstrated a hiatal hernia and near-obstructing gastric mucosal prolapse into the esophageal lumen upon coughing (Figure 1) .There was spontaneous reduction of the mucosal prolapse with abatement of coughing.Figure: Near-obstructing gastric mucosal prolapse into the esophageal lumen.Discussion: The cause of GMP has been attributed to laxity in the mucous membranes at the gastroesophageal junction (GEJ), allowing for vertical movement of the gastric mucosa. Various mechanisms for of such vertical movement of gastric mucosa have been proposed, which include- relaxation at the GEJ, disproportionate redundancy of the gastric mucosa, retrograde gastric peristalsis, and continuous retching and vomiting due to increased intraabdomial pressures. GMP has been reported in patients with history of nonsteroidal anti-inflammatory drug (NSAID) use, alcohol use, gastroenteritis, hyperemesis gravidarum, uremia, malignancy and duodenal ulcers. GMP has a reported incidence rate of 2-5.5% with a prevalence rate of 13.5% in patients with gastroesophageal reflux disease (GERD). GMP has about 90% male preponderance. Patients often present with epigastric pain, hematemesis and recurrent retching. It has been reported that among patients with hiatus hernias and GERD it may present as abdominal pain with reflux symptoms refractory to medical therapy. GMP is diagnosed with EGD or radiographic imaging (barium swallow study). Gastroenterologists should be keenly aware of this entity in order to make an accurate diagnosis and provide timely treatment." @default.
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- W2913050002 date "2017-10-01" @default.
- W2913050002 modified "2023-09-26" @default.
- W2913050002 title "An Impressive Case of Large Gastric Mucosal Prolapse With Refractory Dyspepsia" @default.
- W2913050002 doi "https://doi.org/10.14309/00000434-201710001-02599" @default.
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