Association between Meckel's diverticulum and Crohn's disease: a retrospective review.

Abstract

The operation notes and pathology records of 294 consecutive patients who had right hemicolectomy for Crohn's disease were reviewed. A Meckel's diverticulum was found in 17 (5 8%) ofthese patients, 2-3 times the expected rate in the general population. At least 50% of diverticula in the normal population contain heterotopic mucosa, but none was found in those diverticula that were examined from this group. The increased prevalence of Meckel's diverticulum in patients with Crohn's disease confirms previous anecdotal reports, but the cause for the increased frequency remains unexplained. The significance of this finding is discussed. (Gut 1994; 35: 788-790) There have been suggestions that Meckel's diverticulum is found more commonly in patients diagnosed as having terminal ileal Crohn's disease than in the general population.' It is not understood why this might be. We have recently described a patient who was thought to have Crohn's disease, but at laparotomy, a Meckel's diverticulum was found at the point where the extensive terminal ileal ulceration began. The histological findings in this case were more consistent with chronic inflammation caused by acid secretion from heterotopic gastric epithelium within the diverticulum than with Crohn's disease (unpublished data).The question then arose as to whether there was a real increase in the incidence of Meckel's diverticulum in patients considered to have Crohn's disease or whether this association could, in some cases, be accounted for by acid secretion from the diverticula giving rise to peptic ulceration mimicking Crohn's disease.

Crohn’s disease in a Meckel’s diverticulum: report of a case

“…Prompted by anecdotal reports of an increased incidence of Meckel's diverticulum in Crohn's disease, Andreyev et al [1], on the basis of a review of 294 consecutive right hemicolectomy specimens, found an incidence of 5.4% in patients with Crohn's disease. They concluded that this represented a two-to threefold increase in the incidence of Meckel's diverticulum over the general population [1].…”

“…One large study suggested an increased incidence of Meckel's diverticulum in patients with the disease [1], and another refuted this assertion [2]. Although clearly there are cases of Meckel's diverticulum found at the time of operation for Crohn's disease, including the assertion that an acid-secreting diverticulum may mimic the disease [3], it is rare for the diverticulum to be involved with Crohn's disease [4].…”

Iron Deficiency Anaemia: An Unusual Complication of Meckel’s Diverticulum

“…The normal colonoscopy ruled out inflammatory bowel disease of the large bowel. Meckel's diverticulum is thought to occur much more often in association with Crohn's disease [9]. Endoscopy was not performed on our patient so we could not exclude Crohn's disease involving the small bowel.…”

A case of Meckel’s diverticulitis treated on the assumption of Crohn’s disease

“…It has been recorded in patients with CD, with some authors reporting an incidence of 6% to 18.5% (8). In their review of 294 patients with CD, Andreyev et al (9) found the prevalence of MD to be up to 3 times above that of the general population. However, Freeman (5) recently found 877 patients with CD, among whom 10 (about 1%) had a diagnosis of MD, including 6 men and 4 women, with a prevalence similar to the general population.…”