Abstract
Adding to the five cases previously reported, three new cases of heterotopic gastric mucosa in the rectum are presented, including the first to show mucosa of purely the pyloric type. The literature pertaining to the subject is reviewed and evidence for both acquired and congenital mechanisms for such heterotopias is evaluated in the light of the findings in 87 cases of gastric heterotopia in the files of this laboratory. It would appear from this study that the etiology of heterotopic gastric epithelium anywhere in the alimentary tract is developmental (1) if more than one type of epithelium participates in the process, or (2) if the heterotopia consists of full thickness, completely structured, gastric fundic mucosa. On the other hand, the heterotopia is probably acquired (1) if the tissue is exclusively pyloric glandular epithelium, or (2) if there are only scattered chief and parietal cells.

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