Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 16, Number 10, October 2025, pages 401-405

A Rare Co-Occurrence of Gastric Heterotopia and Autonomic Nervous System Dysfunction: An Attempt to Explain If There Is a Need to Explore Possible Syndromic Link

Figures

↓  Figure 1. Colonoscopy showing gastric heterotopia identified in the rectum with traditional white light endoscopy (left) as well as narrow band imaging (right). The heterotopia is a 15-mm well circumscribed erythematous patch.
Figure 1.
↓  Figure 2. Computed tomography imaging did not reveal any abnormality. There was no evidence of malignancy.
Figure 2.
↓  Figure 3. Summary of steps in the diagnosis.
Figure 3.

Table

↓  Table 1. Blood Test and Corresponding Result at the Time of Initial Presentation to GP
 
Blood test Result Normal reference range
ESR: erythrocyte sedimentation rate; GP: general practitioner; MCV: mean corpuscular volume; RBC: red blood cell; TSH: thyroid-stimulating hormone; WBC: white blood cell.
Hemoglobin 139.0 g/L 130 - 170 g/L
WBC 3.2 ×109/L 3.7 - 11.1 × 109/L
Platelet 209 × 109/L 150 - 450 × 109/L
RBC 4.50 × 1012/L 4.6 - 6.2 × 1012/L
Hematocrit 0.397 L/L 0.4 - 0.5 L/L
MCV 88.2 fL 80 - 101 fL
Mean cell hemoglobin level 30.9 pg 27 - 32 pg
Mean cell hemoglobin concentration 350 g/L 290 - 360 g/L
Neutrophil 1.9 × 109/L 1.7 - 7.5 × 109/L
Lymphocyte 0.7 × 109/L 0.9 - 3.2 × 109/L
Monocyte 0.4 × 109/L 0.2 - 1 × 109/L
Eosinophil 0.2 × 109/L 0 - 0.5 × 109/L
Basophil 0.0 × 109/L 0 - 0.1 × 109/L
ESR 6 mm/h 1 - 12 mm/h
Vitamin B12 level 195 ng/L 144 - 915 ng/L
Folate 18.8 µg/L 3.1 - 19.9 µg/L
Ferritin 64 ng/mL 23.9 - 333.2 ng/mL
TSH 0.662 mIU/L 0.34 - 5.6 mIU/L