Gastric heterotopia in the cervical esophagus (GHC) is a relatively common endoscopic
finding, with a reported incidence of up to 13%. Although it is mostly asymptomatic,
GHC has been associated with symptoms of gastroesophageal reflux (GER), as well as
complications such as stenosis or even neoplasms.
We present the case of a 70-year-old woman referred to our center for evaluation due
to GER symptoms and debilitating cough of several years' duration, refractory to treatment
with esomeprazole at a dose of 40 mg every 12 hours, prokinetics, and antacids. During
the inicial endoscopy, only two islands of GHC were described, one measuring 2 cm
and the other 1 cm, along with a hiatal hernia of less than 2 cm. High-resolution
manometry showed no pathological alterations, and pH monitoring indicated mild reflux.
Given the described symptoms, it was suspected to be secondary to GHC, so the patient
consented to radiofrequency ablation outside the technical file. After the first session,
the patient reported significant clinical improvement, with a reduced requirement
for esomeprazole. At the next follow-up, the 2 cm island had disappeared, and the
1 cm island was treated.
The recommended treatment for GHC is PPI, followed by endoscopic treatment. While
initial recommendations include mucosal resection and submucosal dissection, recent
years have shown that radiofrequency is a safe and effective technique for endoscopic
therapy [1]
[2].
