It must be distinguished from retrograde small molecule library screening prolapse of the stomach, which is much more common and which may resemble at endoscopy its intussusceptive cousin. Gastroesophageal intussusception involves all layers of the stomach, whereas with retrograde prolapse, only the gastric mucosa passes into the esophagus.

One predisposing factor involves poor fixation of the stomach, often a result of laxity or absence of gastrophrenic, gastrohepatic, gastrosplenic, and gastrocolic ligaments as well as the omental attachments. Other risk factors include increased abdominal pressure during retching or vomiting, physical exertion as with weight lifting, or ascites. Hiatus hernia with a lax phrenoesophageal ligament and various operations such as laparoscopic myotomy and fundoplication also have been cited as risk factors. Intussusception may cause intermittent dysphagia, nausea, and abdominal

pain in patients with predisposing anatomy. If it is diagnosed in a nonemergent setting, it may be reasonable to attempt endoscopic reduction or even gastric fixation, but laparotomy and manual reduction are usually required. “
“A 48-year-old woman was referred to our hospital for evaluation Protease Inhibitor Library cost of a long-stalked gastric polypoid lesion, which was found incidentally during upper endoscopy screening. Her medical history was unremarkable, and she did not describe having any GI symptoms. The results of physical examination were unremarkable. EGD showed a 1.5-cm polypoid lesion with an erythematous head (A) and a long pedicle (B). EUS revealed an anechoic lesion with multiple septae, located superficially to the muscularis mucosa (C). She underwent polypectomy by use of a detachable snare. Gross pathologic examination revealed multiple internal cystic portions that were seen on serial sections (D). Microscopic pathologic

examination showed disruption of the muscularis mucosa (arrow) and invaginated cystic glands of varying sizes in the submucosa ( E) compatible with gastritis O-methylated flavonoid cystica profunda. All authors disclosed no financial relationships relevant to this publication. Although the condition was first described in 1947 by Scott and Payne, it wasn’t until 1972 that Littler and Glibermann suggested that the presence of cystically dilated gastric glands in the submucosa was a reactive, postsurgical condition for which they coined the term “gastritis cystica polyposa.” Subsequently the preferred term became “gastritis cystica profunda” (GCP) because it resembled the similarly named condition in the colon. The accepted pathogenesis of GCP is thought to be related to several factors working in concert: something that predisposes to mucosal defects (eg, surgery, biopsy, polypectomy), with chronic ischemia and inflammation, all allowing for mucosal prolapse and herniation of glands into the submucosa.