Editorial

Inlet Patch: An Inconspicuous Lesion Needs More Spotlight

Authors: Chung-Wang Ko, MD, Chi-Sen Chang, MD

Abstract

Esophageal inlet patch is considered a congenital anomaly, a remnant of gastric mucosa which is left behind during the descent of the stomach in embryologic development. It can be found in about 4.5% of infants and up to 12% of children. Its presence is estimated at around 1 to 10% in adults.1 In comparison with Barrett esophagus, which was first described in 1950 by Norman Barrett, the prevalence is not low. However, for most primary care physicians and some gastroenterologists, inlet patch of esophagus is an easily unperceived lesion. It has not gotten much attention since first being described in 1805. Currently, fewer than 50 articles related to inlet patch have been published in MEDLINE.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Bohman-Manesh F, Farnum JB. Incidence of heterotopic gastric mucosa in the upper oesophagus.Gut 1991;32:968–972.
 
2. Maconi G, Pace F, Vago L, et al. Prevalence and clinical features of heterotopic gastric mucosa in the upper oesophagus (inlet patch). Eur J Gastroenterol Hepatol 2000;12:745–749.
 
3. Chong VH, Jalihal A. Cervical Inlet Patch: Case Series and Literature Review. South Med J2006;99:865–869.
 
4. Macha S, Reddy S, Rabah R, et al. Inlet patch: heterotopic gastric mucosa-another contributor to supraesophageal symptoms? J Pediatr 2005;147:379–382.
 
5. Silvers WS, Levine JS, Poole JA, et al. Inlet patch of gastric mucosa in upper esophagus causing chronic cough and vocal cord dysfunction. Ann Allergy Asthma Immunol 2006;96:112–115.
 
6. Akbayir N, Sokmen HM, Calis AB, et al. Heterotopic gastric mucosa in the cervical esophagus: could this play a role in the pathogenesis of laryngopharyngeal reflux in a subgroup of patients with posterior laryngitis? Scand J Gastroenterol 2005;40:1149–1156.
 
7. Sontag SJ, Schnell T, Chejfec G, et al. Barrett’s esophagus is found in half of all patients with cervical inlet patch. Gastroenterology 1999;116:A316.
 
8. Malhi-Chowla N, Ringley RK, Wolfsen HC. Gastric metaplasia of the proximal esophagus associated with esophageal adenocarcinoma and Barrett’s esophagus: what is the connection? Inlet patch revisited. Dig Dis 2000;18:183–185.
 
9. Avidan B, Sonnenberg A, Chejfec G, et al. Is there a link between cervical inlet patch and Barrett’s esophagus? Gastrointest Endosc 2001;53:717–721.
 
10. Lauwers GY, Mino M, Ban S, et al. Cytokeratins 7 and 20 and mucin core protein expression in esophageal cervical inlet patch. Am J Surg Pathol 2005;29:437–442.