Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (6): 126-130.doi: 10.6040/j.issn.1673-3770.0.2024.110

• Clinical Report • Previous Articles     Next Articles

A case of infantile hypopharyngeal gastric mucosal ectasia causing pharyngeal reflux symptoms and review of the literature

YAO Tingting, ZHANG Delun, LI Lan   

  1. Department of Otorhinolaryngology, Shenzhen Children's Hospital, Shenzhen 518034, Guangdong, China
  • Published:2024-12-13

PDF (PC)

195

Abstract: Objective To explore the diagnosis and treatment options for pharyngeal reflux symptoms caused by gastric mucosal ectasia in the hypopharynx. Methods The medical records of a 4-month-old boy were reviewed. The child was admitted to the hospital with "laryngeal tinnitus with episodic dyspnea". The diagnosis of laryngopharyngeal reflux was made on the basis of the child's medical history, laryngoscopic findings, and the RSI scale score. Two spherical masses at the junction of the larynx and the esophageal inlet were examined by electron laryngoscopy and surgically removed. Pathology suggested that the masses were an ectopic gastric mucosa. Results At follow-up examinations at 3 months, 1 year and 3 years after surgery, the children's respiratory and swallowing functions improved significantly and there was no recurrence of the masses. Conclusion Ectopic gastric mucosa in the hypopharynx is rarely reported. In the process of diagnosing pharyngeal reflux in children, if mucosal lesions or masses are found in the pharynx, the possibility of gastric mucosal ectasia should be alerted. Surgical resection of the mass is the mainstay of treatment, and proton pump inhibitors can be used to control reflux symptoms during treatment.

Key words: Heterotopic gastric mucosa, Pharyngeal reflux, Laryngeal ringing, Episodes of dyspnoea, Children

CLC Number: 

  • R766.5
[1] Itai Y, Kogure T, Akiyama H. Ectopic gastric mucosa of the esophagus(1st. report)[J]. JJpnBronchoesophagolSoc, 1972, 23(4): 207-212. doi:10.2468/jbes.23.207
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会咽喉组,中华医学会耳鼻咽喉头颈外科学分会咽喉学组,中华医学会耳鼻咽喉头颈外科学分会嗓音学组. 咽喉反流性疾病诊断与治疗专家共识(2022年,修订版)[J]. 中华耳鼻咽喉头颈外科杂志,2022,57(10):1149-1172. DOI:10.3760/cma.j.cn115330-20220711-00428
[3] Feurle GE, Helmstaedter V, Buehring A, et al. Distinct immunohistochemical findings in columnar epithelium of esophageal inlet patch and of Barrett's esophagus[J]. Dig Dis Sci, 1990, 35(1): 86-92. doi:10.1007/BF01537228
[4] Mannan AASR, Vieth M, Khararjian A, et al. The outlet patch: gastric heterotopia of the colorectum and anus[J]. Histopathology, 2018, 73(2): 220-229. doi:10.1111/his.13632
[5] von Rahden BHA, Stein HJ, Becker K, et al. Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopathologic classification[J]. Am J Gastroenterol, 2004, 99(3): 543-551. doi:10.1111/j.1572-0241.2004.04082.x
[6] di Palmo E, Cazzato S, Tursini S, et al. A rare association of inlet patch with laryngospasm: a report of two children and literature review[J]. Pediatr Pulmonol, 2011, 46(9): 934-938. doi:10.1002/ppul.21457
[7] Georges A, Coopman S, Rebeuh J, et al. Inlet patch: clinical presentation and outcome in children[J]. J Pediatr Gastroenterol Nutr, 2011, 52(4): 419-423. doi:10.1097/MPG.0b013e3181f2a913
[8] 龙峻标, 于淑霞, 刘绍能. 食管上段异位胃黏膜69例临床分析[J]. 中华消化杂志, 2013, 33(5): 336-338. doi:10.3760/cma.j.issn.0254-1432.2013.05.012
[9] 陈维安, 崔颖鹏, 李春亿, 等. 小儿异位胃粘膜核素显像的诊断价值[J]. 中国儿童保健杂志, 2005, 13(4): 314-315. doi:10.3969/j.issn.1008-6579.2005.04.014 CHEN Weian, CUI Yingpeng, LI Chunyi, et al. Diagnostic value of radionuclide imaging in children with ectopic gastric mucosa[J]. Chinese Journal of Child Health Care, 2005, 13(4): 314-315. doi:10.3969/j.issn.1008-6579.2005.04.014
[10] 靳水, 王瑞华, 刘艳, 等. SPECT/CT显像诊断异位胃黏膜的临床价值[J]. 中华核医学与分子影像杂志, 2016, 36(3): 229-231. doi:10.3760/cma.j.issn.2095-2848.2016.03.006 JIN Shui, WANG Ruihua, LIU Yan, et al. Clinical value of SPECT/CT imaging in the diagnosis of ectopic gastric mucosa[J]. Chinese Journal of Nuclear Medicine and Molecular Imaging, 2016, 36(3): 229-231. doi:10.3760/cma.j.issn.2095-2848.2016.03.006
[11] 吴迪盼盼, 崔新华, 郭颖, 等. 窄带成像技术在咽喉反流诊断中的优势应用[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 31-36. doi:10.6040/j.issn.1673-3770.1.2020.108 WU Dipanpan, CUI Xinhua, GUO Ying, et al. Narrow band imaging might contribute to the diagnosis of laryngopharyngeal reflux[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 31-36. doi:10.6040/j.issn.1673-3770.1.2020.108
[12] 黄娟秀. NBI在食管上段胃粘膜异位症的临床应用[J]. 临床医药文献电子杂志, 2020, 7(32): 125-126. doi:10.16281/j.cnki.jocml.2020.32.110
[13] Yin Y, Li HY, Feng J, et al. Prevalence and clinical and endoscopic characteristics of cervical inlet patch(heterotopic gastric mucosa): a systematic review and meta-analysis[J]. J Clin Gastroenterol, 2022, 56(3): e250-e262. doi:10.1097/MCG.0000000000001516
[14] Romańczyk, M, Budzyń K, Romańczyk, T. et al. Heterotopic Gastric Mucosa in the Proximal Esophagus: Prospective Study and Systematic Review on Relationships with Endoscopic Findings and Clinical Data[J]. Dysphagia, 2023, 38(2): 629-640. doi: 10.1007/s00455-022-10492-8.
[15] Silvers WS, Levine JS, Poole JA, et al. Inlet patch of gastric mucosa in upper esophagus causing chronic cough and vocal cord dysfunction[J]. Ann Allergy Asthma Immunol, 2006, 96(1): 112-115. doi:10.1016/S1081-1206(10)61049-6
[16] Chong VH, Jalihal A. Cervical inlet patch: case series and literature review[J]. South Med J, 2006, 99(8): 865-869. doi:10.1097/01.smj.0000231246.28273.b0
[17] Ayres L, Perring S, Nouraei SAR. A multidisciplinary approach to identifying and managing heterotopic gastric inlet patches[J]. Neurogastroenterol Motil, 2024, 36(4): e14768. doi:10.1111/nmo.14768
[18] 李洪秋, 李红, 常筱颖, 等. 小儿异位胃黏膜致消化道出血的特点及处理[J]. 中国小儿急救医学, 2007, 14(5): 446-447. doi:10.3760/cma.j.issn.1673-4912.2007.05.030 LI Hongqiu, LI Hong, CHANG Xiaoying, et al. Clinical feature and treatment of digestive bleeding with ectopic gastric mucosa in children[J]. Chinese Pediatric Emergency Medicine, 2007, 14(5): 446-447. doi:10.3760/cma.j.issn.1673-4912.2007.05.030
[19] Daher P, Riachy E, Zeidan S, et al. Upper airway obstructive symptoms because of ectopic gastric mucosa in a newborn: a case report[J]. J Pediatr Surg, 2006, 41(8): e7-e9. doi:10.1016/j.jpedsurg.2006.04.005
[20] Weinstock MS, Simons JP, Dohar JE. Heterotopic gastric mucosa of the proximal esophageal(HGMPE)and its potential role in pediatric dysphonia and dysphagia[J]. Int J Pediatr Otorhinolaryngol, 2020, 138: 110271. doi:10.1016/j.ijporl.2020.110271 [PubMed]
[1] ZHU Xiqian, WANG Jia, SUN Zuxian, FENG Jianxiu, ZHANG Mengjia, ZHAO Ying, WANG Hong, JIANG Minmin. Refractive status of school-aged children aged 6-9 years in Yangpu District, Shanghai, 2022-2024: a cohort study [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(3): 102-109.
[2] SONG Yanling, SI Yuanyuan, CUI Yan. Minimal quantity vitrectomy for laser-pointer induced full-thickness macular hole in a child: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 144-147.
[3] LIU Nanxian, YANG Zeyin, HAN Lin, ZHANG Aiying, ZHAO Yuliang, XUE Jing, SUN Yijun, SHAO Yongliang. Significance of video-EEG in the diagnosis of recurrent vertigo in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 20-25.
[4] HUANG Huan, HUA Hongli, DENG Yuqin, JIANG Chengyang, WANG Yuwei, YANG Xinghai. Correlation of allergic rhinitis, tonsil adenoid hypertrophy, and sinusitis in children and analysis of its clinical guiding value [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 34-41.
[5] WANG Hua, ZHANG Fengzhen, LONG Ting, ZHAO Jing, LI Hongbin, WANG Shengcai, WANG Guixiang. Analysis of the reasons and prognostic outcomes for tracheostomy in pediatric patients following posterior fossa tumor resection [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 168-173.
[6] HUANG Aiping, WANG Juan, WANG Li, GENG Jiangqiao, WANG Yafang, WEN Xin. Tonsil Burkitt lymphoma involving pulmonary and maxilla in children: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 148-152.
[7] LIU Chang, YANG Jingpu, GAO Yu, WANG Wenjia. Analysis of allergen detection results in children with allergic rhinitis in the Changchun area [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 51-58.
[8] FU Shengyao, CHEN Min, PANG Wenhui, LI Na. Endoscopic-assisted individualized surgical approach for the treatment of nasal dermoid and sinus cysts in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 65-71.
[9] CHEN Danping, HE Zijian, YU Youjun, ZHOU Xiaowei. Analysis of the efficacy and prognostic factors of hospitalized cases of children with sudden sensorineural hearing loss for ten years [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 16-22.
[10] YANG Na, LIU Yin, GUO Bao, JI Yaofeng, CHENG Chen, ZHANG Chen, DONG Lina. High frequency ultrasound in closed reduction of nasal fracture in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 41-45.
[11] WANG Dengmao, WEN Xin, GENG Jiangqiao, ZHANG Guangyuan, LIU Xiaofeng. Tubal hair polyp complicated with nasopharyngeal hamartoma in children: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 105-109.
[12] WU Wei, WANG Lei, CHEN Sheng, LI Lianyong, WANG Gang. Multidisciplinary research and advances in gastro-oesophageal reflux disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 1-14.
[13] LIU Lianlian, LI Jinrang. Obstructive sleep apnea and laryngopharyngeal reflux [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 15-22.
[14] ZHANG Li, ZHANG Mengru, Alimire Aierken, QIU Zhongmin. Role of pharyngeal reflux in common respiratory diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 23-29.
[15] HU Zhiwei, CHEN Dong, YANG Dong, WU Jimin. Diagnosis and treatment of gastroesophageal airway reflux disease: based on related consensus and guidelines from 2020 to 2024 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 30-38.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd