Acid secretion from a Meckel's diverticulum: the unsuspected mimic of Crohn's disease?

The commonest causes of ulceration in the terminal ileum are Crohn's disease, infection, and neoplasia. Meckel's diverticulum is said to be found more commonly in patients with Crohn's disease than in the general population. We describe a patient who developed extensive terminal ileal ulceration caused by acid secretion from gastric mucosa within a Meckel's diverticulum, a condition that has not been recognized before. Our patient demonstrated a number of clinical features that would be consistent with Crohn's disease, and we wonder whether the rare condition of "Meckel's ileitis" is occasionally misdiagnosed as Crohn's disease in other patients.