Anorectal gastric heterotopia as a rare cause of constipation: Case report and review of pediatric literature.

Gastric heterotropia (GHT) may present from the oropharynx to the anus and is commonly associated with Meckel's diverticula. Here, we describe a rare case of anorectal GHT localized to the distal anal canal. A 14-month-old male patient presented for evaluation of rectal bleeding, severe constipation, and abdominal distention with poor response to laxative medications. Physical examination revealed anal stenosis, and the patient underwent rectal examination under anesthesia with anal dilation and a full-thickness rectal biopsy, which revealed GHT. Cutback anoplasty relieved the stenosis, and due to the risk of dysplasia, surgical resection and pull-through were discussed. The care team and family elected medical management with chronic acid suppression given the distal location of the GHT. All pediatric case reports of anorectal GHTs to date are reviewed. This is one of few associated with anal stenosis, and the second to be managed exclusively nonsurgically.