P0310 - Esophageal Inlet Patch: Prevalence and Association to Barrett’s Esophagus

Rishabh Khatri, MD¹, Jay Patel, MD¹, Jun Song, MD¹, Dariush Shahsavari, MD², Zubair Malik, MD³, Henry P. Parkman, MD^1
1Temple University Hospital, Philadelphia, PA; ²Temple University School of Medicine, Philadelphia, PA; ³Temple University, Philadelphia, PA

Introduction: Esophageal inlet patch (IP) are ectopic location of gastric mucosa in the proximal esophagus, identified on esophagogastroduodenoscopy (EGD) procedures as pink, round or ovular patches in the proximal esophagus. The prevalence of IP and its possible association to Barrett’s Esophagus (BE) has been suggested. We investigated patients with IP who presented for endoscopic procedures at our institution.

Methods: We retrospectively analyzed EGD reports for patients age ≥ 18 years who had EGD completed from January 2010 to December 2020 at our institution. Patients were separated on whether IP and BE was present on EGD. Patient demographic data including age, gender, BMI, race (Caucasian, Hispanic, African-American, or other), ethnicity (Hispanic or non-Hispanic), alcohol (current or never) and tobacco (current, prior, or never) use were recorded on patients with evidence of IP in EGD.

Results: Of 25,010 unique patients who underwent EGD during the study period, 362 (1.4%) had inlet patch findings. Of these IP patients, 62 of the 362 patients (17.1%) had endoscopic evidence of Barrett’s Esophagus in comparison to 1243 (4.9%) of the 25,010 patients in this study period (p< 0.001). Additionally, in patients without IP who had BE, were older than patients without BE (p < 0.001) as well had statistical significance between gender, with high contribution from males (p < 0.001). Overall, of the 362 IP patients,182 (50.5%) were males, mean age 51.5 ± 15.6 years, and BMI 28.9 ± 6.9 kg/m². Racial distribution entailed 96 (26.4%) Hispanic, 182 (50%) Caucasian, 69 (19.6%) African-American with 100 (27.5%) patients identified as ethnically Hispanic. Additionally, 210 (57.9%) IP patients endorsed current alcohol use. Comparing IP patients with BE to IP patients without BE, the mean age of patients was higher in patients with BE and IP, compared to BE alone (p=0.044). There was significant correlation between gender, with male contributing more than female (p < 0.001), race (0.002), and alcohol use (0.043), but not BMI (0.939), ethnicity (0.198) and tobacco use (0.836) in patients with IP.

Discussion: IP was detected in 1.4% of upper endoscopies at our institution with higher prevalence in patients with BE (4.9%). Furthermore patients with BE and IP, were found to be older age, male gender, Caucasian race, and had decreased consumption of alcohol compared to BE alone. Whereas, BMI, ethnicity, and tobacco use were not. Identification of IP on EGD should lead to careful evaluation of the esophagus for BE.

Patients with EGD completed from 2010-2020 n=25010		Patients without BE and No IP N=23767 [X2contribution]		Patients with BE and No IP N=1243 [X2contribution]		P-value	Inlet Patch Demographics N=362		Patients Without Barrett’s Esophagus N=300 [X2contribution]	Patients With Barrett’s Esophagus N=62 [X2contribution]	p- Value
Mean Age ± STD (54.8 ± 15) years		53.8 ± 16		58.9 ± 13		< 0.001*	Mean Age ± STD (51.5±15.6) years		50.8 ± 15.7	55.2 ± 14.9	0.044*
							Mean BMI ± STD (28.9±6.9) kg/m2		28.9 ± 7.14	28.9 ± 5.8	0.939*
Gender	Male 10039 (40.1%)		9461 [5.48]		756 [101]		Gender	182 (50.5%) Male	134 [1.39]	45 [6.71]	< 0.001
	Female 14791 (59.1%)		14606 [3.7]		549 [68.16]	< 0.001		180 (49.5%) Female	166 [1.36]	17 [6.56]
							Race	96 (26.4%) Hispanic	84 [0.27]	12 [1.3]	0.002
								182 (50% Caucasian)	138 [1.02]	44 [4.98]
								69 (19.6% African-American)	63 [0.63]	6 [2.98]
								15 (4% Other)	15 [0.24]	0
							Ethnicity	100 (27.5%) Hispanic	87 [0.21]	13 [0.99]	0.198
								262 (72.5%) Non-Hispanic	213 [0.08]	49 [0.38]
							Alcohol Use	210 (57.9%) Current drinkers	182 [0.29]	29 [1.41]	0.043
								152 (43.1%) Non-drinkers	118 [0.41]	33 [1.97]
							Tobacco Use (Smoking)	176 (48%) Never	148 [0.03]	28 [0.15]	0.836

Table: Prevalence and Demographic Data of Patients who Underwent EGD between 2010-2020: Barrett's Esophagus and Inlet Patch
*Student's t-test



Disclosures:
Rishabh Khatri indicated no relevant financial relationships.
Jay Patel indicated no relevant financial relationships.
Jun Song indicated no relevant financial relationships.
Dariush Shahsavari indicated no relevant financial relationships.
Zubair Malik indicated no relevant financial relationships.
Henry Parkman indicated no relevant financial relationships.


Rishabh Khatri, MD¹, Jay Patel, MD¹, Jun Song, MD¹, Dariush Shahsavari, MD², Zubair Malik, MD³, Henry P. Parkman, MD¹. P0310 - Esophageal Inlet Patch: Prevalence and Association to Barrett’s Esophagus, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.