NZ Society of Gastroenterology Abstracts to NZSG & NZgNC Annual Scientific Meeting 2026 Abstracts

Introduction: An esophageal inlet patch is an area of heterotopic gastric mucosa, with a population prevalence up to 11%.In a recent meta-analysis from the American Journal of Gastroenterology, it was shown that argon plasma coagulation (APC) and radiofrequency ablation are effective treatments for inlet patch-related dysphagia, globus, and heartburn.Clinical Case: PT is a 50-year-old gentleman with a background of hypertension and asthma who presented with months of dysphagia, globus sensation, cough, and regular throat clearing.A trial of omeprazole caused no change in his symptoms.Gastroscopy noted two inlet patches in the upper third of the esophagus, a 3-cm hiatus hernia, and no evidence of reflux esophagitis.Random esophageal biopsies showed squamous mucosa with no diagnostic abnormalities.Barium swallow was normal with no evidence of pharyngeal pouch, tertiary contractions, or reflux.Esophageal manometry confirmed normal esophageal peristalsis and bolus transit, with a mildly hypotensive UES of uncertain clinical significance.Through his life insurance company, PT received an international expert review of his symptoms where it was advised to consider ablation of the inlet patches.This was subsequently undertaken in two stages, 4 weeks apart, with the use of APC under light sedation.The second procedure was ketamine assisted.At that time, it was noted the previously treated inlet patch had resolved post APC.Following the above procedures, a short course of omeprazole and viscous lignocaine was given.At his 1-month follow-up, PT's symptoms had completely resolved, and he had returned to eating normally.Conclusions: This case highlights upper esophageal symptoms caused by an inlet patch, which resolved on ablation of the ectopic tissue highlighting both a novel diagnosis and treatment pathway for refractory dysphagia, globus sensation, cough, and throat clearing symptoms.