Chen WG, Zhu HT, Yang M, Xu GQ, Chen LH, Chen HT. Large heterotopic gastric mucosa and a concomitant diverticulum in the rectum: Clinical experience and endoscopic management. World J Gastroenterol 2018; 24(30): 3462-3468 [PMID: 30122884 DOI: 10.3748/wjg.v24.i30.3462]
Corresponding Author of This Article
Hong-Tan Chen, MD, Chief Doctor, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun road, Hangzhou 310003, Zhejiang Province, China. 1510026@zju.edu.cn.
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wen-Guo Chen, Hua-Tuo Zhu, Ming Yang, Guo-Qiang Xu, Li-Hua Chen, Hong-Tan Chen, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Chen WG wrote the paper; Zhu HT collected and analyzed the data; Yang M performed the research; Xu GQ and Chen LH were study supervisors; Chen HT conceived and designed the study; all the authors approved the final version of the article to be published.
Supported bythe National Natural Science Foundation of China, No. 81600413 and No. 81600414.
Informed consent statement: Written informed consent was provided by the patient prior to study inclusion. All details that might disclose the identity of the subject were omitted or anonymized.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hong-Tan Chen, MD, Chief Doctor, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun road, Hangzhou 310003, Zhejiang Province, China. 1510026@zju.edu.cn.
Telephone: +86-571-87236729 Fax: +86-571-87236611
Received: May 25, 2018 Peer-review started: May 26, 2018 First decision: July 6, 2018 Revised: July 9, 2018 Accepted: July 16, 2018 Article in press: July 16, 2018 Published online: August 14, 2018
ARTICLE HIGHLIGHTS
Case characteristics
A 14-year-old girl visited our hospital due to a 5-year history of repeated hematochezia.
Clinical diagnosis
Heterotopic gastric mucosa (HGM) and a concomitant diverticulum in the rectum found through colonoscopy examination.
Differential diagnosis
Ulcerative colitis.
Laboratory diagnosis
CA 19-9 was 61.2 U/mL, hemoglobin was 116 g/L, and stool occult blood examination was weakly positive. Other laboratory results were close to normal.
Imaging diagnosis
At colonoscopy, a solitary superficial depressed lesion, approximately 5 cm in size, with a diverticular cavity was identified in the rectum. Abdominal computed tomography revealed no obvious gastrointestinal lesions.
Pathological diagnosis
The pathology test confirmed the diagnosis of HGM.
Treatment
Endoscopic submucosal dissection.
Related reports
To the best of our knowledge, this is the first report of large HGM lesion and a concomitant diverticulum in the rectum treated by endoscopic submucosal dissection (ESD).
Term explanation
HGM is the most commonly reported epithelial heterotopia and has been described as heteroplasia in organogenesis or metaplasia during the repair of damaged epithelium.
Experiences and lessons
ESD is thought to be the safe and efficient treatment for HGM.
