Acute gastrointestinal bleeding due to Meckel's diverticulum heterotopic gastric mucosa.

R Maieron, D Stimac, C Avellini, L Zoratti, C Rizzi, C Scott, M Rubinić, C A Beltrami, G L Da Broi
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Abstract

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract occurring in approximately 2% of the population. In our retrospective study, we analyzed 58 surgical specimens of Meckel's diverticulum operated on in our hospital. Heterotopic gastric mucosa was found in ten. Aim of this study was to establish the aetiopathogenesis of inflammation and consequent haemorrhage in Meckel's diverticulum with heterotopic gastric mucosa. Some studies showed that Helicobacter-like bacteria could play an important role in determining local phlogosis in heterotopic gastric mucosa of Meckel's diverticulum, however, none were found in our biopsy specimens. Analyzing patients with acute intestinal haemorrhage (4 out of 10 with heterotopic gastric mucosa) in Meckel's diverticulum a history of previous oral administration of NSAID's was positive in 3 of them. Although in the recent literature there were few case reports on the use of NSAID's and bleeding from Meckel's diverticulum, our results suggest that even short-term use, in small quantities, of NSAID's can play an important role in determining acute bleeding from Meckel's diverticulum with heterotopic gastric mucosa.

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梅克尔憩室异位胃黏膜致急性消化道出血。
梅克尔憩室是最常见的胃肠道先天性异常,约占人口的2%。在我们的回顾性研究中,我们分析了58例在我院手术的梅克尔憩室的手术标本。10例胃黏膜异位。本研究旨在探讨胃粘膜异位的梅克尔憩室炎症及出血的病因机制。一些研究表明,幽门螺杆菌样细菌在Meckel憩室异位胃黏膜局部炎中可能起重要作用,但我们的活检标本中未发现此类细菌。分析Meckel憩室急性肠出血患者(10例胃粘膜异位患者中有4例),其中3例既往口服非甾体抗炎药史阳性。虽然在最近的文献中,很少有关于使用非甾体抗炎药和梅克尔憩室出血的病例报道,但我们的研究结果表明,即使短期少量使用非甾体抗炎药,也可以在确定异位胃粘膜的梅克尔憩室急性出血中发挥重要作用。
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NSAID gastropathy: state of the art. Epidemiological aspects of NSAID gastropathy. Therapy of NSAIDs-induced gastropathy. Endoscopic aspects of gastroduodenal mucosa due to NSAIDs. Histopathological aspects of mucosal injury related to non-steroidal anti-inflammatory drugs.
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