Ectopic gastric mucosa and glandular tissue of a salivary type in the anal canal concomitant with a diverticulum in hemorrhoidal tissue: Report of a case

Shindo, Katsuhisa; Bacon, Earry E.; Holmes, Elizabeth J.

doi:10.1007/bf02587671

Cited by 31 publications

(9 citation statements)

References 16 publications

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“…Although intestinal duplications are extremely rare [ 93 ], with rectal duplications being more so (1–8% of all cases) [ 94 , 95 ], rectal duplication was the most prevalent malformation being observed in 12 cases (71%). Other malformations of the GI and genitourinary tracts and skeletal system occurred in eight cases and were generally multiple: anal stenosis and sacrococcygeal defect (‘Currarino triad’) [ 38 , 56 ]; digital anomalies (clino- and syndactylia) [ 49 ]; myelomeningocele, malplaced (anterior) and imperforate anus [ 55 ]; enterocloacal fistula, multiple genitourinary abnormalities, malrotation and/or partial atresia of the colon [ 39 , 44 ]; spina bifida, pectus excavatum and bicornate uterus [ 39 ]; scoliosis [ 42 , 47 ] and Meckel’s diverticulum [ 38 , 55 ]. Rectal duplication and other malformations were combined in four cases [ 38 , 42 , 49 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

Heterotopic gastric mucosa in the anus and rectum: first case report of endoscopic submucosal dissection and systematic review

Iacopini

Gotoda

Elisei

et al. 2016

Gastroenterol. Rep.

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Background: Heterotopic gastric mucosa (HGM) is the most reported epithelial heterotopia, but it is very rare in the rectum and anus.Methods: The first case of an asymptomatic adult male with a large nonpolypoid HGM in the low rectum underwent complete resection by endoscopic submucosal dissection (ESD) is reported. The systematic review was based on a comprehensive search of MEDLINE, EMBASE and Google Scholar. Studies on humans were identified with the term ‘heterotopic gastric mucosa in the rectum and /or anus.’Results: The search identified 79 citations, and 72 cases were evaluated comprising the present report. Congenital malformations were observed in 17 (24%) patients; rectal duplication accounted for most of the cases. The HGM was located in the anus and perineal rectum in 25 cases (41%) and low, middle and proximal pelvic rectum in 20 (33%), five (8%) and 11 cases (18%), respectively. Morphology was nonpolypoid in 37 cases (51%), polypoid in 26 cases (36%) and ulcerated in nine cases (13%). Specific anorectal symptoms were reported by 50 (69%) patients of the whole study population, and by 33 (97%) of 34 patients ≤ 18 years. Complications were observed in 23 cases (32%). The HGM was excised in 50 cases (83%). Endoscopic resection was performed in 17 cases (34%); resection was piecemeal in five of 12 lesions ≥15 mm, required argon plasma coagulation in two cases and was associated with residual tissue in two (17%). Intestinal metaplasia and an adenoma with low-grade dysplasia were described in three adults (4%).Discussion: This systematic review shows that the HGM in the rectum and anus may be associated with specific rectal symptoms and serious complications, mainly in the pediatric population, and a risk of malignancy in adults. Its complete excision should be recommended, and the ESD can overcome the technical limits of conventional endoscopic snare resection and avoid unnecessary surgery.

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Section: Resultsmentioning

confidence: 99%

Heterotopic gastric mucosa in the anus and rectum: first case report of endoscopic submucosal dissection and systematic review

Iacopini

Gotoda

Elisei

et al. 2016

Gastroenterol. Rep.

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“…Rough endoplasmic reticulums, mitochondria, free ribosome and Golgi apparatus were also found in the cells. der (29, 32), and anal canal (36). Meckel's diverticulum contains all layers of the intestinal wall, but some cases have ectopic mucosa identical to that found in the stomach, duodenum, colon or pancreas (12, 39).…”

Section: Resultsmentioning

confidence: 99%

Heterotopic Gastric Mucosa of the Small Intestine in Laboratory Beagle Dogs

Iwata¹,

Arai

Koike³

et al. 1990

Toxicol Pathol

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Out of the 365 young laboratory beagle dogs which were used in 17 toxicity bioassays, 15 cases (4.1%) were diagnosed as having congenital heterotopic gastric mucosa of the small intestine. Its incidence in the male dogs (12 cases out of 187) was higher than in the female dogs (3 cases out of 178). Grossly, the lesions were seen as an ulcerous focus of the small intestine, 25 cm to 88 cm proximal to the ileocecal valve. All of the lesions were quite similar histologically and electron microscopically to the normal gastric mucosa, which are composed of the surface mucous cells, chief cells, parietal cells, mucous neck cells and basal granulated cells of the stomach. And consequently, they were considered to be that of a congenital heterotopic tissue in the small intestine. The only morphological characteristic of these lesions different from the regular gastric mucosa was an association with the tubular structure seen in the basal region of these mucosal layers. These cells were considered to be of mucous-secreting cell origin because of secreting type III mucous evident from paradoxical concanavalin A or periodic acid Schiff stains. They seemed to be protecting the surrounding intestinal mucosa from gastric acid.

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“…It refers to the finding of normal tissues in abnormal locations [5]. Heterotopia in the rectum is relatively rare, but HGE [6,7,9] and salivary gland heterotopia (SGH) [2,8] are well known. HGE is more commonly seen.…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have described heterotopic gastric epithelium (HGE) [6,7,9], salivary gland tissue [2,8], and pancreas [4] in the rectum. However, heterotopic respiratory mucosa (HRM) has not been reported in the literature at any site along the gastrointestinal tract including the rectum.…”

Section: Introductionmentioning

confidence: 98%

Heterotopic respiratory mucosa in the rectum: A first case report

2007

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A 50-year-old Japanese woman consulted our hospital complaining of hematochezia. Colonoscopic examination showed Borrmann type 1 rectal carcinoma in the lower rectum, which was later demonstrated to be mucinous adenocarcinoma of Dukes' class A. Along with carcinoma, there was a small sessile polyp with a central depression that mimicked a submucosal tumor. Histologically, the polyp demonstrated tubular structures that coursed from the top of the polypoid surface to the deep submucosa. The tubular structure was 6 mm in length and showed abortive dichotomous branching. It was mainly lined by ciliated pseudostratified columnar to more cuboidal epithelium. Along with the tubular structure, there were bundles of smooth muscle cells and lobules of seromucinous glands. There was no cartilage. The pathological diagnosis was heterotopic respiratory mucosa (HRM) arising in the rectum. To our knowledge, this is the first reported case of HRM in the rectum.

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Ectopic gastric mucosa and glandular tissue of a salivary type in the anal canal concomitant with a diverticulum in hemorrhoidal tissue: Report of a case

Cited by 31 publications

References 16 publications

Heterotopic gastric mucosa in the anus and rectum: first case report of endoscopic submucosal dissection and systematic review

Heterotopic gastric mucosa in the anus and rectum: first case report of endoscopic submucosal dissection and systematic review

Heterotopic Gastric Mucosa of the Small Intestine in Laboratory Beagle Dogs

Heterotopic respiratory mucosa in the rectum: A first case report

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