Heterotopia of the gastric mucosa in the rectum: a clinical case report

Abstract

Heterotopic gastric mucosa is rare in the paediatric population, but it can pose a diagnostic challenge. This pathology can occur in any part of the digestive tract, from the oropharynx to the anorectal area. Most cases are observed in the esophagus, duodenum and hepatobiliary system, but the presence of this tissue in the rectum is extremely rare. Purpose - conduct a clinical description of a rare pathology in children in order to pay the doctors` attention to the need for comprehensive diagnosis of patients with hematochezia. Clinical case. We present a clinical case of a child with heterotopia of the gastric mucosa into the rectum. Symptoms included hematochezia and anal pain during the act of defecation, general weakness, and decreased appetite. These manifestations were observed for two years with periods of exacerbations and remissions on the background of conservative treatment. The final diagnosis was made on the basis of a biopsy of nodular formations of the rectum, detected by colonoscopy. Conclusions. Given the negative impact of the disease manifestations on the patient's quality of life and the potential risk of malignant transformation, the possibility of heterotopic gastric mucosa in the rectum with indeterminate bleeding from the lower gastrointestinal tract should be considered and a complete examination, including biopsy, should be performed. Once the diagnosis is confirmed, radical surgical removal is recommended. Initial conservative treatment with proton pump inhibitors provides only short-term relief and is accompanied by periods of exacerbation and remission. The final treatment is always surgical or endoscopic excision of the heterotopic mucosa. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.