Heterotopic gastric mucosa in the proximal esophagus manifesting as upper gastrointestinal bleeding: An uncommon presentation

Abstract

Heterotopic gastric mucosa of the proximal esophagus (HGMPE) also referred to as inlet patch is a salmon-colored patch located just distal to the upper esophageal sphincter. HGMPE is usually asymptomatic detected incidentally during endoscopy. Its clinical significance is mainly acid-related or neoplastic complications. Here, we present a case of a 58-year female presenting in the casualty with two episodes of upper gastrointestinal (UGI) bleeding. UGI Endoscopy revealed a large esophageal ulcer 1.5 cm × 1 cm just below the upper esophageal sphincter (UES). Biopsy from this area revealed a diagnosis of HGMPE. UGI bleed occurring as a complication of inlet patch has been very rarely reported. Only one case in literature is present making this case report the second one. This case highlights the importance of careful endoscopic evaluation of the UES region along with biopsy which may reveal heterotopic gastric mucosa in patients with unexplained UGI bleed.