Isolated Heterotopic Gastric Mucosa of the Upper Esophagus / 대한소화기내시경학회지

BACKGROUND: Isolated heterotopic gastric mucosa of the upper esophagus(HGME), often referred to as inlet patch, is an asyptomatic benign lesion. It may, however, cause retrosternal chest pain and dysphagea, and rarely produce complications such as ulceration and stricture. It may be suspected on characteristic finding of endoscopy, and the diagnosis is usually proved by biposy. We studied several characteristics of HGME. METHOD: From January 1996 to May 1997, endoscopy was performed on 2000 consecutive patients (1068 male, 932 female). HGME was seen 25 patients(12 male, 13 female) among 2000 patients. RESULT: Prevalence of HGME is 1.25%. There was no significant difference of the prevalence of HGME between male and female. HGME was presented as a velvety and salmon-pink patch with a distict border from the normally pale squamous cell mucosa of the esophagus, and was seen as multiple lesions in 8 patients among 25 patients. Thirty three locailzed gastric mucosal patches, varying in size 3 mm to 30 mm in the longest diameter, were detected within or just below of upper esophageal spincter in all the twenty five patients. Biopsy specimens taken from the miucosal patches demonstrated gastric mucosa. Among 25 patients with HGME, four patients complained foreign body sensation on throat or heartburn, without other diseases such as GERD, gastritis or peptic ulcer. CONCLUSION: Further studies of a large scale about pathogenesis, prevalence, and complication of HGME will be required.

A Case of Multiple Small Nodular Peritoneal Mesothelioma / 대한소화기내시경학회지

Peritoneal mesothelioma is a rare disease which arises from the mesothelial lining cells in the peritoneum and spreads to the peritoneal wall, omentum and other abdomina1 organs. Aabestos is one etiologic factor and the other factors are genetic cause, radiation, exposure to toxic materials and recurrent yeritonitis. We experienced a case of multiple small nodular peritoneal mesothelioma after exposure to asbestos for over 20 years. He was a sailor and had worked in the engine department of the ship, in which he wrapped up the pipe of engine in asbestos. This person came to our hospital because of inconvenience due to a distended abdomen. Tumor markers were all within normal limits and there was no evidence of tuberculosis in the abdomen and chest. The CT findings of the abdomen were as follows: There was abundant ascites in the abdominal cavity and multiple small nodules on the parietal peritoneum and especially on the lower abdomen. The omentum thickened diffusely. It was difficult to distinguish from peritoneal mesothelioma and peritoneal carcinomatosis or intestinal tuberculosis. The laparoscopic findings were as follows: There were multiple small nodules on the parietal peritoneum and omentum. The small nodules were a gray white color and uneven compared to tuberculous peritonitis. Therefore, we observed the malignant mesothelial cells by means of the light microscope and electron microscope and concluded that this case was peritoneal mesothelioma.