Gastric Heterotopia of the Rectum: A Case Report

摘要

We report a case of gastric heterotopia found in the rectum during colonoscopic examination of a 34-year-old female. The lesion was diagnosed in a patient who presented with a change in bowel habits and other intestinal complaints. The decision was made to perform an elective colonoscopic examination with biopsy of a suspicious area in the rectum. Pathologic examination of the biopsy specimen confirmed the diagnosis of gastric heterotopia. A thorough review of the literature reveals that only 40 cases of gastric heterotopia have been reported in the rectum, and most of these were identified as single, sessile polyps. This case highlights the importance of recognizing this unusual histologic entity. Introduction Ectopic gastric mucosa has been described at various locations in the body including the mouth, esophagus, duodenum, pancreas, biliary system, small bowel, mediastinum, scrotum, bladder, and spinal cord (1). Nevertheless, gastric heterotopia of the rectum is a rare finding, with only 40 cases reported in the literature to date. We describe a case of gastric heterotopia in the rectum and review the potential manifestations, likely etiologies, and diagnostic pitfalls for this unusual biopsy finding. Case Report A 34-year old female presented with altered bowel habits, abdominal bloating, excessive “intestinal noise,” visible abdominal distention, and occasional nausea. She denied any rectal bleeding, and had no family history of colon cancer. The patient had undergone a colonoscopy approximately four years prior secondary to irritable bowel syndrome complaints. The colonoscopic examination was normal at that time. Colonoscopic examination at the current presentation revealed the colonic mucosa to be normal. A single non-bleeding smooth polyp, described as salmon in color, was seen in the rectum that measured 1.5cm. The affected area was slightly raised, sessile, and well circumscribed. There appeared to be some furrowing within this “polyp”. Dyes were not originally applied, and magnification endoscopy unavailable. This polyp did not involve the anal verge and showed no stigmata of recent hemorrhage (Figure 1).