PMC4531699_01
A. Esophagoscopic findings of the patch showing a diameter that is between one-quarter and one-half fully expanded. B. Endoscopic biopsy of the heterotopic gastric mucosa in the upper esophageal sphincter area showing the histology of fundic type gastric mucosa (H & E stain, x100).
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Upon withdrawal of the endoscope, a patch of salmon colored epithelium was clearly demarcated from the surrounding normal mucosa in the upper esophagus (Figure 1A). Endoscopic biopsy finding from the patches revealed gastric-type columnar epithelium with parietal cells and Helicobacter pylori was not found on the Giemsa stain (Figure 1B).
24-hour ambulatory pH monitoring of the upper and lower esophagus (top). The upper esophageal pH dropped below four without falling in the lower esophageal pH (arrow) in the supine position (bottom).
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Despite the increased acid exposure in the proximal pH probe, there was no acid reflux in supine position from 15:45 to 16:10 (Figure 2).