Abstract
Extensive heterotopic gastric mucosa of the small intestine is a rare, but potentially life-threatening condition characterized by multifocal or long-segment heterotopic gastric mucosa within the bowel lumen that is often associated with other anomalies including malrotation and annular pancreas. Although the imaging findings are characteristic, this entity may be unrecognized due to its unusual imaging appearance and rarity. CT or MR enterography and 99mTc-sodium pertechnetate scintigraphy can provide complementary information that enables specific diagnosis and accurate assessment of disease extent. We present a case of extensive heterotopic gastric mucosa of the small intestine imaged by simultaneous, combined 99mTc-sodium pertechnetate single photon-emission computed tomography (SPECT)/CT enterography to both familiarize the reader with the condition and describe an imaging strategy that enables specific diagnosis and assists with treatment planning.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Turck D, Bonnevalle M, Gottrand F et al (1990) Intraoperative endoscopic diagnosis of heterotopic gastric mucosa in the ileum causing recurrent acute intussusception. J Pediatr Gastroenterol Nutr 11:275–278
Lambert MP, Heller DS, Bethel C (2000) Extensive gastric heterotopia of the small intestine resulting in massive gastrointestinal bleeding, bowel perforation, and death: report of a case and review of the literature. Pediatr Dev Pathol 3:277–280
Kiratli PO, Aksoy T, Bozkurt MF et al (2009) Detection of ectopic gastric mucosa using 99mTc pertechnetate: review of the literature. Ann Nucl Med 23:97–105
Jimenez JC, Emil S, Steinmetz B et al (2005) Recurrent gastrointestinal tract bleeding secondary to jejunal gastric heterotopia. J Pediatr Surg 40:1654–1657
Heinrichs VM, Kemper MJ, Burdelski M et al (1997) Disseminated islands of gastric mucosa in jejunum and ileum detected by technetium-99m-pertechnetate scintigraphy. J Nucl Med 38:818–820
Bueno RC, Hardman JM, Shim WK (2001) Intraoperative localization of ectopic gastric mucosa in the nonduplicated intestinal lumen with technetium 99 m pertechnetate scanning. J Pediatr Surg 36:1720–1721
Shehata B, Chang T, Greene C et al (2011) Gastric heterotopia with extensive involvement of the small intestine associated with congenital short bowel syndrome and intestinal malrotation. Fetal Pediatr Pathol 30:60–63
Sfakianakis GN, Conway JJ (1981) Detection of ectopic gastric mucosa in Meckel’s diverticulum and in other aberrations by scintigraphy: I. Pathophysiology and 10-year clinical experience. J Nucl Med 22:647–654
Acknowledgments
Dr. Trout receives grant support from Siemens Healthcare, travel support for being on the advisory board of Philips Healthcare and reports being an author for Elsevier.
Authors thank technologists Joby MacLean and Erica Gates, without whom coordinating this study would not have been feasible, and staff pathologist Dr. Anita Gupta for assistance with pathological images.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None
Rights and permissions
About this article
Cite this article
Schapiro, A.H., Lin, T.K., Frischer, J.S. et al. Extensive heterotopic gastric mucosa of the small intestine: imaging with 99mTc-sodium pertechnetate SPECT/CT enterography. Pediatr Radiol 46, 1873–1878 (2016). https://doi.org/10.1007/s00247-016-3687-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-016-3687-7