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Gastric Gland Metaplasia in the Ileal Blind Loop I. Yokoyama 1,3 , S. Kozuka 2 , K. Ito 1,3 , T. Kondo 1 , K. Ota 3 12nd Department of Surgery, Nagoya University School of Medicine 22nd Department of Pathology, Nagoya University School of Medicine 3Nagoya Clinic pp.659-662
Published Date 1977/5/25
DOI https://doi.org/10.11477/mf.1403112638
  • Abstract
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 Congenitally developed gastric heterotopia in the organs other than the stomach is frequently seen in patients with Meckel's diverticulum and less frequently in intestinal duplication. On the other hand, acquired type of gastric metaplasia is that of pseudopyloric gland found in the duodenum and small and large intestine. The true gastric metaplasia in the intestine below the ligament of Treitz, however, had not been reported until 1963 when Ming et al. described a case of regional ileitis in which he represented true gastric gland in the ileum. Another report by Trier et al. in 1973 was on ectopic gastric mucosa in the jejunum with celiac sprue.

 This is a case report of gastric metaplasia in the ileal blind loop. The patient, a 56-year-old man, had undergone side-to-side ileal bypass surgery because of acute intestinal obstruction twenty years previously. The specimen of the ileal blind loop resected recently due to recurrent intestinal obstruction disclosed patchy appearance of true gastric glands consisting of chief cells, parietal cells and mucous neck cells. The true gastric glands were considered to represent an acquired metaplasia because there was an extensive pseudopyloric gland metaplasia in the mucosa of the specimen, in which dilated cystic glands were scattered in the deep zone of the mucosa propria, occasionally showing transformation from dilated cystic glands into pseudopyloric glands or true gastric glands. Moreover, both dilated cystic glands and pseudopyloric glands seemed to be closely related to ulcer healing. Therefore, true gastric gland is considered to be derived from metaplastic pseudopyloric gland, probably under the influence of alterations of intestinal condition such as long-standing ulcerative process, stasis of the intestinal contents, and so on.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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