The inlet patch: heterotopic gastric mucosa in the upper esophagus.

Careful endoscopic survey of the upper esophagus indicates that a visually recognizable patch of gastric mucosa is grossly visible much more commonly than is generally recognized. Sixteen instances were found in 420 sequential endoscopies, an incidence of 3.8%. The gastric mucosal rest presented as a velvety red patch with a distinct border, varying from a few millimeters in diameter to complete encirclement of the esophagus, was occasionally paired, and was found either at or just below the upper esophageal sphincter. In all instances except one the patch consisted of gastric-type mucosa containing both parietal and chief cells; in the single exception, it consisted of gastric-type mucous glands without parietal cells. Although larger patches can be shown to function under stimulation (they produce a local drop in pH with pentagastrin stimulation), there are usually no apparent associated clinical symptoms.