Heterotopic Gastric Mucosa Causing Rectal Bleeding in a Young Child

JPGN reports · 4 authors, 3 centres

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TL;DR

Rectal bleeding decreased with proton pump inhibitor therapy and recurred after PPI cessation.

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This case report describes an 8-year-old male with eosinophilic esophagitis presenting with worsening intermittent hematochezia. There was no evidence of granulomas, cryptitis, dysplasia, or malignancy. Rectal bleeding decreased when the patient was placed on a proton pump inhibitor for eosinophilic esophagitis and recurred after PPI cessation. A Meckel scan was negative despite biopsy-confirmed HGM, consistent with literature reporting low yield of Meckel scans for rectal HGM.

STUDY TYPE

case_report

SPECIALTY

pediatrics

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100% · A

ORIGINAL PAPER

PMC10158372

Heterotopic Gastric Mucosa Causing Rectal Bleeding in a Young Child

JPGN reports

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ABSTRACT

Heterotopic gastric mucosa (HGM) in the colon and small bowel is a very rare finding. We report a case of HGM in the rectum of an 8-year-old child with a history of eosinophilic esophagitis after having a colonoscopy to evaluate for inflammatory bowel disease. The colonoscopy was normal except for rectal tissue erythema and edema. Inflammatory bowel disease has been reported in some cases of children with eosinophilic changes of the esophagus. The child had intermittent rectal bleeding thought to be due to constipation. Interestingly, when the patient was placed on a proton pump inhibitor for the treatment of eosinophilic esophagitis, the rectal bleeding decreased. After our patient ceased proton pump inhibitor therapy, he experienced a large amount of rectal bleeding. Histological findings revealed HGM in the colon/rectum. An extensive review of the incidence, diagnosis, and treatment is discussed.

CITATION EXPORT

Blake Patricia-Rae Meyer, Johnny Nguyen, Michael Wilsey et al.. Heterotopic Gastric Mucosa Causing Rectal Bleeding in a Young Child. JPGN reports. (2022). https://doi.org/10.1097/PG9.0000000000000184

AUTHORS

4 · 3 CENTRES

Blake Patricia-Rae Meyer, Johnny Nguyen, Michael Wilsey, Sara Karjoo

*Florida State University College of Medicine, Tallahassee, FL
†Department of Pathology, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
‡Department of Gastroenterology, Johns Hopkins All Children’s Hospital, St. Petersburg, FL.