Recurrent small intestinal perforation from gastric mucosal heterotopia: A case report

Background: Gastric mucosal heterotopia (GMH) is a rare, typically asymptomatic condition characterized by ectopic gastric mucosa in tissues outside the stomach. However, it can lead to severe complications, including small intestinal perforation. This case report highlights the unique clinical presentation of GMH-induced recurrent small intestinal perforations, which has been rarely documented. These findings emphasize the importance of considering GMH in patients with unexplained recurrent gastrointestinal perforations.

Case summary: A 13-year-old female presented with acute abdominal pain. Her medical history included four prior surgeries for small intestinal perforations. Enhanced computed tomography revealed localized bowel thickening and perforation, prompting emergency surgery. A 20 cm segment of the ileum was resected and anastomosed. Pathological analysis confirmed extensive GMH with ulceration and perforation, identifying GMH as the cause of the recurrent perforations. Postoperatively, the patient recovered well with no recurrence by the 10-month follow-up.

Conclusion: GMH should be considered in cases of recurrent unexplained intestinal perforations.