{"id":2285,"date":"2019-12-31T19:32:06","date_gmt":"2019-12-31T18:32:06","guid":{"rendered":"https:\/\/angh.net\/abstracts\/heterotopie-de-la-muqueuse-gastrique-hmg-de-loesophage-proximal-une-entite-encore-meconnue\/"},"modified":"2021-10-06T14:17:33","modified_gmt":"2021-10-06T12:17:33","slug":"heterotopie-de-la-muqueuse-gastrique-hmg-de-loesophage-proximal-une-entite-encore-meconnue","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/heterotopie-de-la-muqueuse-gastrique-hmg-de-loesophage-proximal-une-entite-encore-meconnue\/","title":{"rendered":"H\u00e9t\u00e9rotopie de la muqueuse gastrique (HMG) de l\u2019\u0153sophage proximal : une entit\u00e9 encore m\u00e9connue."},"content":{"rendered":"

2019<\/strong><\/p>\n

A Sarhani, J. Verlynde, T. Paupard. Service d\u2019H\u00e9pato-Gastroent\u00e9rologie. 130. Av. L. Herbeaux-Centre Hospitalier de Dunkerque-59385 Cedex 1 Dunkerque.<\/em><\/p>\n

Gastroent\u00e9rologie\u00a0<\/strong>– \u00a02019-04-04 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Introduction :
\nL\u2019h\u00e9t\u00e9rotopie de la muqueuse gastrique (HMG) correspond \u00e0 un \u00eelot de muqueuse gastrique au sein de la muqueuse \u0153sophagienne. Ces foyers de muqueuse m\u00e9taplasique peuvent si\u00e9ger tout au long du tube digestif et rarement au niveau du tiers sup\u00e9rieur de l\u2019\u0153sophage. La physiopathologie de l\u2019HMG au tiers sup\u00e9rieur de l\u2019\u0153sophage reste mal connue. Elle semble diff\u00e9rente de celle de l\u2019endobrachyoesophage (EBO). Deux hypoth\u00e8ses existent, mais la 2\u00e8me est consid\u00e9r\u00e9e comme la principale : 1) Une pathologie acquise en association \u00e0 un reflux gastro-\u0153sophagien comme pour l\u2019EBO du tiers distal de l\u2019\u0153sophage ; 2) Une malformation cong\u00e9nitale constitu\u00e9e tr\u00e8s t\u00f4t au cours de l\u2019embryog\u00e9n\u00e8se. La pr\u00e9valence de l\u2019HMG de l\u2019\u0153sophage proximal est mal connue et est estim\u00e9e \u00e0 environ 3% des patients examin\u00e9s par gastroscopie.
\nL\u2019objectif de ce travail est d\u2019estimer dans notre centre la pr\u00e9valence de l\u2019HMG, les signes cliniques, endoscopiques, les aspects microscopiques et les diff\u00e9rents facteurs \u00e9pid\u00e9miologiques associ\u00e9s \u00e0 partir d\u2019une courte s\u00e9rie r\u00e9trospective.
\nPatients et m\u00e9thode :
\nTous les patients d\u2019un seul centre d\u2019endoscopie avec une HMG du tiers sup\u00e9rieur de l\u2019\u0153sophage ont \u00e9t\u00e9 inclus sur une p\u00e9riode d\u2019\u00e9valuation de 5 mois. Toutes les l\u00e9sions vues en endoscopie ont \u00e9t\u00e9 confirm\u00e9es par l\u2019analyse histologique. L\u2019examen endoscopique \u00e9tait r\u00e9alis\u00e9 sans coloration sp\u00e9cifique.
\nR\u00e9sultats :
\n736 malades ont b\u00e9n\u00e9fici\u00e9 d\u2019une gastroscopie pendant 5 mois (entre mai 2018 et septembre 2018), Une HMG du tiers sup\u00e9rieur de l\u2019\u0153sophage a \u00e9t\u00e9 d\u00e9couverte chez 10 malades. Il s\u2019agissait de 8 hommes et de 2 femmes avec un \u00e2ge moyen de 55 ans (extr\u00eames : 26-69). Deux patients sur 10 \u00e9taient tabagiques. L\u2019endoscopie digestive haute \u00e9tait demand\u00e9e pour des manifestations cliniques de reflux gastro-\u0153sophagien chez 8 patients. Les deux autres indications concernaient un bilan d\u2019an\u00e9mie ferriprive et une recherche de signes d\u2019HTP. Les manifestations cliniques \u00e9taient domin\u00e9es par une dyspepsie (66%), des \u00e9pigastralgies (50%), un pyrosis (33%) et des r\u00e9gurgitations (16%). Les l\u00e9sions endoscopiques associ\u00e9es \u00e0 l\u2019HMG \u00e9taient les suivantes : gastrite (7\/10), hernie hiatale (1\/10). Les l\u00e9sions d\u2019HMG apparaissaient sous la forme d\u2019ilots arrondis, suspendus, de couleur \u00ab rouge saumon \u00bb, bien d\u00e9limit\u00e9s, mesurant en moyenne 1.75 cm (extr\u00eames : 1.5 et 2 cm), au nombre de 2 dans 50% des cas, si\u00e9geant en moyenne \u00e0 17,5 cm (extr\u00eames : 13 et 20 cm) des arcades dentaires. L\u2019\u00e9tude histologique confirmait l\u2019aspect de cellules glandulaires typiquement fundiques, avec pr\u00e9sence de m\u00e9taplasie intestinale dans 30% des cas au sein de l\u2019HMG. Un seul patient avait une infection \u00e0 H\u00e9licobacter pylori. Aucune dysplasie n\u2019\u00e9tait visualis\u00e9e au sein de l\u2019HMG.
\nConclusion :
\nL\u2019HMG de l\u2019\u0153sophage proximal constitue une anomalie b\u00e9nigne d\u00e9couverte le plus souvent de fa\u00e7on fortuite en endoscopie. Dans notre courte s\u00e9rie r\u00e9trospective la pr\u00e9valence estim\u00e9e est de 1,3% avec une nette pr\u00e9dominance masculine. Aucune dysplasie n\u2019a \u00e9t\u00e9 mise en \u00e9vidence. Ne s\u2019agissant pas d\u2019une \u00e9tude prospective, dans notre centre la pr\u00e9valence est surement sous-\u00e9valu\u00e9e. Ainsi, au cours d\u2019une gastroscopie, un examen attentif du tiers sup\u00e9rieur de l\u2019\u0153sophage au retrait de l\u2019appareil est indispensable, pour d\u00e9pister d\u2019\u00e9ventuelles plages d\u2019HMG. Les biopsies doivent \u00eatre syst\u00e9matiques pour confirmation du diagnostic et recherche de dysplasie. L\u2019HMG reste m\u00e9connue, sous-estim\u00e9e et de diagnostic difficile. En raison de donn\u00e9es de suivis \u00e9volutifs insuffisantes dans la litt\u00e9rature, sa prise en charge reste d\u00e9battue et pourrait s\u2019apparenter \u00e0 celle de l\u2019EBO pour la surveillance et la prise en charge th\u00e9rapeutique, notamment en cas de sympt\u00f4mes ou de dysplasie av\u00e9r\u00e9e. Une \u00e9tude prospective sous la forme d\u2019un observatoire multicentrique pourrait aider \u00e0 pr\u00e9ciser la pr\u00e9valence de cette affection et son profil \u00e9volutif au cours du temps.<\/p>\n","protected":false},"excerpt":{"rendered":"

2019 A Sarhani, J. Verlynde, T. Paupard. Service d\u2019H\u00e9pato-Gastroent\u00e9rologie. 130. Av. L. Herbeaux-Centre Hospitalier de Dunkerque-59385 Cedex 1 Dunkerque. Gastroent\u00e9rologie\u00a0– \u00a02019-04-04 –\u00a0CO – ________________________________ Introduction : L\u2019h\u00e9t\u00e9rotopie de la muqueuse gastrique (HMG) correspond \u00e0 un \u00eelot de muqueuse gastrique au sein de la muqueuse \u0153sophagienne. Ces foyers de muqueuse m\u00e9taplasique peuvent si\u00e9ger tout au long […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[30],"class_list":["post-2285","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-30"],"yoast_head":"\nH\u00e9t\u00e9rotopie de la muqueuse gastrique (HMG) de l\u2019\u0153sophage proximal : une entit\u00e9 encore m\u00e9connue. - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/heterotopie-de-la-muqueuse-gastrique-hmg-de-loesophage-proximal-une-entite-encore-meconnue\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"H\u00e9t\u00e9rotopie de la muqueuse gastrique (HMG) de l\u2019\u0153sophage proximal : une entit\u00e9 encore m\u00e9connue. - 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