High oesophageal web formation in association with heterotopic gastric mucosa (the gastric inlet patch): a small case series

BACKGROUNDUpper oesophageal webs or rings have rarely been reported in association with heterotopic gastric mucosa (HGM). OBJECTIVETo describe the finding of oesophageal webs in association with HGM. DESIGNSmall case series. SETTINGPatients presenting with dysphagia to an open access hospital dysphagia clinic. PATIENTSSix cases were found. INTERVENTIONSSymptomatic improvement is demonstrated with oesophageal dilatation in symptomatic patients. MAIN OUTCOME MEASUREMENTSSymptomatic improvement. RESULTSThe six cases which are described here demonstrate that a web or ring exactly matches the distribution of the heterotopic mucosa, can occur at both proximal and distal squamo-columnar junctions and the inlet patches may be multiple with multiple rings. A radiological double web sign is described. LIMITATIONSA rare condition with a small number of patients. CONCLUSIONSEffective treatment can be by oesophageal dilatation and acid suppression. The cause of web formation is thought to be due to heterotopic acid production and is analogous to the Schatzki ring.