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

Background Upper oesophageal webs or rings have rarely been reported in association with heterotopic gastric mucosa (HGM). Objective To describe the finding of oesophageal webs in association with HGM. Design Small case series. Setting Patients presenting with dysphagia to an open access hospital dysphagia clinic. Patients Six cases were found. Interventions Symptomatic improvement is demonstrated with oesophageal dilatation in symptomatic patients. Main outcome measurements Symptomatic improvement. Results The 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. Limitations A rare condition with a small number of patients. Conclusions Effective 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.