ABSTRACT
BACKGROUND: Gastric heterotopia is a rare congenital lesion, described everywhere in the body, but involves predominantly the digestive tract. Diagnosis is based on histologic examination and requires the presence of gastric mucosa, especially fundic. This diagnosis is usually easy, but sometimes it can be misinterpreted as gastric metapalsia . This latter is an acquired and frequent lesion of the gastrointestinal tract. AIMS: To determine the relationship between this affection and the other digestive malformations, to describe the clinical characteristics and the evolution of this lesion and to discuss the differential diagnosis particularly the gastric metaplasia. METHODS: Twelve cases of gastric heterotopia were diagnosed over a 12-year period at Habib Thameur Hospital. Clinical data was obtained and all the slides were reviewed. RESULTS: Nine cases were found in Meckel's diverticulum (75%), one case in intestinal duplication, one case in the esophagus and another in the gallbladder. The mean age of patients at diagnosis was 16 years with a peak of incidence at the first decade of life. Intestinal obstruction and digestive bleeding were the most presenting features. Heterotopic gastric mucosa complicates other congenital anomalies such as common mesentery, vestigial polyp of the liver, appendiceal agenesis and heterotopic pancreas. Differential diagnosis consists in gastric metaplasia was found extensively in a patient with Crohn's disease associated with Meckel's diverticulum. CONCLUSION: Gastric heterotopia is frequently associated with congenital anomalies especially with Meckel's diverticulum and digestive duplication. Diagnosis relies on histology, mainly on finding heterotopic fundic glands in normal organizational structure. Sometimes, differentiating between gastric heterotopia and gastric metaplasia requires clinical confrontation.
Subject(s)
Choristoma/diagnosis , Choristoma/etiology , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/etiology , Stomach , Adolescent , Adult , Child , Child, Preschool , Choristoma/epidemiology , Choristoma/pathology , Cohort Studies , Diagnosis, Differential , Digestive System Abnormalities/complications , Digestive System Abnormalities/diagnosis , Digestive System Abnormalities/epidemiology , Disease Progression , Esophageal Diseases/diagnosis , Esophageal Diseases/epidemiology , Esophageal Diseases/etiology , Esophageal Diseases/pathology , Female , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/pathology , Humans , Infant , Male , Meckel Diverticulum/pathology , Metaplasia/diagnosis , Metaplasia/epidemiology , Metaplasia/etiology , Middle Aged , Retrospective Studies , Young AdultABSTRACT
AIM: To assess the effect of a single dose of Sildenafil citrate on the visual function in men with early-stage age-related macular degeneration(AMD).METHODS: Forty men (mean age 71, range from 55-86 years)with early-stage AMD were prospectively randomized to receive either placebo or Sildenafil citrate (Viagra; Pfizer Inc, New York, NY) 100mg as a single oral dose. Subjects underwent visual acuity, Amsler grid and color discrimination in each eye before and at specific intervals within 9 hours after dosing.RESULTS: Compared with placebo, no pattern of errors were evident in any visual function test following Sildenafil administration. No statistically or clinically relevant changes from baseline were observed in visual acuity or color discrimination. No clinically relevant changes were observed in the Amsler grid. Sildenafil treatment was associated with transient mild or moderate headache and flushing. CONCLUSION: A single 100mg dose of Sildenafil was well tolerated and produced no significant acute visual effects in a sample of men with early-stage AMD.
