Department of Pathology, Miyagi Children's Hospital, Sendai, Japan.
Fetal Pediatr Pathol. 2022 Oct;41(5):865-870. doi: 10.1080/15513815.2021.1989529. Epub 2021 Oct 15.
Meckel's diverticulum (MD) is a remnant of the omphalomesenteric duct. Although the majority of MD are asymptomatic, it can present with severe hematochezia. Hematochezia is generally considered to result from a peptic ulcer caused by ectopic gastric mucosa in MD. However, this hypothesis has not been proved.
10 cases of surgically resected MD initially presenting with severe hematochezia were histologically examined.
Ectopic gastric mucosa was present in 9 cases, two of which also contained ectopic pancreas. No ectopic tissue was found in one case, which shows that bleeding can occur in MD without ectopic gastric mucosa. In addition, a rupture of aberrant submucosal arterioles through the overlying mucosa, a vascular abnormality called Dieulafoy's lesion, was detected in all the 10 cases.
This study suggests that the actual cause of massive bleeding in MD is not a peptic ulcer, but Dieulafoy's lesion.
梅克尔憩室（MD）是卵黄管的残余物。虽然大多数 MD 无症状，但它可能表现为严重的血便。血便通常被认为是由 MD 中异位胃黏膜引起的消化性溃疡所致。然而，这一假设尚未得到证实。
对 10 例最初表现为严重血便的手术切除的 MD 进行了组织学检查。
9 例存在异位胃黏膜，其中 2 例还含有异位胰腺。1 例未发现异位组织，表明 MD 出血可无异位胃黏膜。此外，所有 10 例均检测到异常黏膜下小动脉通过覆盖的黏膜破裂，这是一种称为迪厄拉富瓦病的血管异常。
本研究表明，MD 大量出血的实际原因不是消化性溃疡，而是迪厄拉富瓦病。
