ECTOPIC GASTRIC-MUCOSA IN THE UPPER ESOPHAGUS - PREVALENCE AND RADIOLOGIC FINDINGS

OBJECTIVE. Ectopic gastric mucosa of the upper esophagus is an asympto matic benign lesion that may simulate a more serious lesion on radiogr aphs. We studied the radiographic findings and prevalence of this abno rmality. SUBJECTS AND METHODS. During a 1-year period, 1142 consecutiv e patients (817 men, 325 women) who had an upper gastrointestinal seri es as part of an annual health checkup were prospectively studied. Rou tine examination of the esophagus consisted only of fluoroscopy. Radio graphs were obtained if any localized irregularities were found in the upper esophageal wall at fluoroscopy, The findings were subsequently confirmed by endoscopy and biopsy. RESULTS. Ectopic gastric mucosa in the upper esophagus was seen in 27 (25 men, two women) of the 1142 pat ients. Forty-three localized ectopic gastric mucosal patches varying i n size from 5 mm to 32 mm were detected at the level of the thoracic i nlet in the 27 patients. The most common radiographic finding was a pa ir of small indentations on the wall of the esophagus (18 patches), Ot her findings included a rimlike shadow (three patches), a pair of some what large indentations with a shallowly depressed area between them ( two patches), one indentation (five patches), a small flat elevation ( one patch), a serrated irregular outline (five radiologic lesions cons isted of 11 patches), other various irregular outlines (two patches), and a polypoid area (one patch). CONCLUSION. Prevalence of radiographi c evidence of ectopic gastric mucosa in the upper esophagus is 2.4%, T he lesion was found more commonly in men (3.1%) than in women (0.6%), Radiographic findings include a pair of indentations along the lateral margin of the esophagus and a rimlike shadow on the anterior or poste rior wall. Recognition of the characteristic radiographic features of this abnormality makes endoscopy and follow-up unnecessary.