Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2018; 24(30): 3462-3468
Published online Aug 14, 2018. doi: 10.3748/wjg.v24.i30.3462
Large heterotopic gastric mucosa and a concomitant diverticulum in the rectum: Clinical experience and endoscopic management
Wen-Guo Chen, Hua-Tuo Zhu, Ming Yang, Guo-Qiang Xu, Li-Hua Chen, Hong-Tan Chen
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 by the 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
Processing time: 80 Days and 1.7 Hours
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.