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• W2977537865 abstract "Introduction: Heterotopic gastric mucosa (HGM) may occur anywhere in the gastrointestinal (GI) tract as single or multifocal lesions, but is rarely found in the rectum. Case Report: A 33 year-old Caucasian woman with history of asthma and bipolar disorder presented to the ER complaining of RLQ abdominal pain, nausea, fevers and chills for 3 days. She denied any similar symptoms in the past. She had no family history of Inflammatory Bowel Disease (IBD) or GI malignancy and was taking no medications. Physical exam was notable for moderate RLQ tenderness. Her laboratory studies were remarkable only for mild leukocytosis. CT scan of the abdomen and pelvis showed evidence of ileocolitis with normal appendix and no signs of obstruction. Symptoms resolved after five days of oral antibiotics. Her ileocolitis was likely secondary to an acute infectious etiology. She was referred to gastroenterology to rule out IBD. A colonoscopy revealed an 8 mm nodule with umbilicated center in the rectum [Fig. 1]. The remainder of the colon appeared normal. Random colon and terminal ileum biopsies were unremarkable. Rectal nodule biopsy showed benign heterotopic gastric fundic-type mucosa. HGM was an incidental finding, unrelated to her RLQ discomfort. Of note, she did not undergo upper endoscopy at that time, thus specimen contamination was ruled out. As patient remained asymptomatic she opted for observation and periodic surveillance with flexible sigmoidoscopy. Endoscopic versus surgical resection were discussed if she becomes symptomatic or develops evidence of neoplasia.Figure 1Discussion: HGM in the rectum may be symptomatic with bowel habit changes, bloating, abdominal pain, rectal burning, pruritus ani, painless rectal bleeding or tenesmus. Ectopic gastric mucosa may secrete acid and even harbor Helicobacter pylori. It may be complicated by ulcer, fistula formation or even perforation. It may also be diagnosed incidentally in an asymptomatic patient. Diagnosis is made via biopsy and histology. Definitive treatment is endoscopic ablation or resection versus surgical excision but treatment with H2 blockers, proton pump inhibitors and Helicobacter pylori eradication is recommended as initial therapy if ulceration is present. The true prevalence and risk for malignant transformation are unknown but intestinal metaplasia and an adenoma with low grade dysplasia have been described in the literature, thus endoscopic surveillance or complete excision should be recommended." @default.
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• W2977537865 date "2016-10-01" @default.
• W2977537865 modified "2023-09-27" @default.
• W2977537865 title "Heterotopic Gastric Mucosa of the Rectum: Case Report" @default.
• W2977537865 doi "https://doi.org/10.14309/00000434-201610001-02602" @default.
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