Cserni G
Bács-Kiskun Megyei Onkormányzat Kórháza, Patológiai Osztály Kecskemét.
Orv Hetil. 1997 Aug 3;138(31):1957-63.
Cases of resected vitellointestinal duct remnants (including Meckel's diverticula, fistulae and a cyst) diagnosed at the Histopathology Department of our hospital between 1956 and 1995 were reviewed for the presence of heterotopic gastric mucosa. The review of the files included the whole archives of the Bács-Kiskun County Hospital. The files contained 166 records of vitellointestinal duct remnant; of these 151 were evaluated and 28 were shown to involve ectopic gastric mucosa. Seven of these latter had no assessable surface mucosa, and therefore only 21 specimens were evaluated for "gastric" histopathologic changes. "Gastritis" was seen in all cases, however the pattern that predominated was that of chemical gastritis, which has not yet been documented at this location. It was present in 57% of cases and could also account for some symptoms leading to the removal of appendices with no histopathologic signs of inflammation. Chronic and chronic active gastritis-like inflammation were also demonstrated in some cases. Those with moderate or severe activity were associated with peptic ulceration or macroerosions. No Helicobacter pylori like organisms were detected with the modified Giemsa stain and haematoxylin & eosin stain. No conclusions could be drawn regarding the role nonsteroidal anti-inflammatory drugs played in erosive gastritis-like diverticulitis because of the lack of information on the use of such agents; however erosions were rare (14%). The fact that the proportion of ectopic gastric mucosa found in several studies (including this one) is about half that suggested by textbooks indicates a need for a more detailed work up of resected Meckel's diverticulum and a search for all kinds of gastric pathology if gastric heterotopia is present. The identification of chemical gastritis like inflammation, which is often viewed and documented as normal mucosa is also important in this process.
回顾了1956年至1995年间在我院组织病理学科诊断的切除卵黄管残余病例（包括梅克尔憩室、瘘管和囊肿），以检查是否存在异位胃黏膜。档案审查包括巴奇-基什孔县医院的全部存档。档案中有166份卵黄管残余记录；其中151份进行了评估，28份显示有异位胃黏膜。后一组中有7份没有可评估的表面黏膜，因此仅对21份标本进行了“胃”组织病理学变化评估。所有病例均可见“胃炎”，然而主要的类型是化学性胃炎，在此部位尚未有相关记录。它存在于57%的病例中，也可以解释一些导致切除无组织病理学炎症迹象阑尾的症状。在一些病例中还发现了慢性和慢性活动性胃炎样炎症。那些具有中度或重度活动性的与消化性溃疡或大糜烂有关。改良吉姆萨染色和苏木精-伊红染色未检测到幽门螺杆菌样微生物。由于缺乏关于此类药物使用的信息，无法就非甾体抗炎药在糜烂性胃炎样憩室炎中的作用得出结论；然而糜烂很少见（14%）。在几项研究（包括本研究）中发现的异位胃黏膜比例约为教科书所提示比例的一半，这一事实表明需要对切除的梅克尔憩室进行更详细的检查，并且如果存在胃异位，要寻找所有类型的胃部病变。在这个过程中，识别通常被视为正常黏膜并记录为化学性胃炎样炎症也很重要。
