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Heterotopic gastric mucosa (HGM) can be found anywhere from the mouth to the rectum. Moreover, anecdotal presence at airways, umbilicus, gallbladder, biliary tree, urinary bladder, and scrotum was reported (1-3). Here we present a 15-year-old girl referred to our clinic with recurrent hematemesis, because of duodenojejunal HGM. Her physical examination was normal except pallor (serum hemoglobin level: 7.2 g/dL). Gastroduodenoscopy revealed a huge, snake-like polypoid lesion obliterating the lumen of the distal duodenum and extending farther (Fig. 1A). Oxyntic mucosa was detected on biopsy specimens by hematoxylin-eosin staining (Fig. 1B). Computed tomography showed a 12 Â 5 cm mobile mass in the lumen of the fourth part of the duodenum. At laparotomy, a mass was found starting approximately from 4 cm proximal to the ligament of Treitz and continued to 8 cm distal of Treitz, and was resected (Fig. 2).HGM is a rare hereditary or acquired condition, usually seen in adults. Children would present with recurrent hematemesis or melena (4). Residual acid and gastrin-secreting tissues are commonly located on the duodenum; however, presence on jejunum, colon, and esophagus has all been described previously (5). Pediatric gastroenterologists should be aware of HGM in patients with upper gastrointestinal (GI) bleeding.

Background Diabetes and hepatosteatosis are dramatically increasing in childhood. Non-alcoholic fatty liver disease (NAFLD) is defined as a common disorder in adulthood, especially with type-2 diabetes and metabolic syndrome, while very few studies are available on liver health in children with type-1 diabetes. Patients and methods One hundred and ten (52 males and 58 females) patients with type-1 diabetes aged between 8 and 18 years were examined. The lipid profile, liver enzymes and hepatobiliary ultrasound findings of patients were investigated in terms of hepatopathies. Patients diagnosed with fatty liver were evaluated by pediatric gastroenterology specialists for the differential diagnosis and exclusion of other etiologies. The relationships between hepatopathy and age, pubertal status, the duration of diabetes and glycemic control were evaluated. Results Hepatopathy was found in 17 (15.5%) patients. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were normal and did not correlate with the ultrasonography (USG) findings. Hyperechogenicity detected by USG, whether it is true fat or glycogen hepatopathy, was found to be associated with “poor glycemic control” independently of age, puberty status and the duration of diabetes. Conclusions This study contributes to the literature in terms of the relationship between liver health and glycemic control in pediatric type-1 diabetes. Hepatopathies were releated with poor glycemic control independently of the duration of diabetes. This suggested that liver disorders should be considered as one of the subacute complications of diabetes. It was concluded that routine screening for comorbidities and complications in type-1 diabetes should also include hepatobiliary USG, as liver enzymes alone are inadequate for detecting hepatopathies.

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