A team from Seattle, USA investigated whether H. pylori colonizes the gastric mucosa of Meckel's diverticula, and determined its relationship to 'gastritis' and bleeding.
A 10-year retrospective review identified 45 children with Meckel's diverticulum.
Hematoxylin-eosin and Diff-Quik stains were used to assess the presence and severity of gastritis, and to highlight organisms in the resected diverticula. Cases with organisms were then studied with antibodies specific for H. pylori using immunoperoxidase methods.
28 children, 7 months to 12 years of age, were found to have lower gastrointestinal hemorrhage caused by Meckel's diverticulum and had positive radionuclide scans. All had acid-secreting mucosa in their diverticula, and ulceration.
'Chronic gastritis' and eosinophilia were constant findings; 'acute gastritis' was present in 4 patients.
|H. pylori not associated with lymphoid follicles in Meckel's diverticula.
|Pediatric Gastroenterology and Nutrition|
20 specimens were found to exhibit lymphoid follicles in the gastric mucosa.
17 patients with Meckel's diverticula (age range, 1 month - 14 years), who presented with acute abdominal pain associated with intussusception were used for comparison. Of these, 4 patients had acid-secreting gastric mucosa.
The researchers identified H. pylori in only 1 of the 45 patients; this patient had ulceration and moderate 'acute gastritis'.
Author Laura S. Finn said on behalf of colleagues, "H. pylori does not colonize a substantial number of children who have ulcerated and bleeding Meckel's diverticulum in the presence of acid-secreting mucosa. Although H. pylori is a notable cause of ulceration, we confirm that ulceration is possible in its absence, and alternative mechanisms of ulceration are important."
"The presence of lymphoid follicles in Meckel's diverticula, unlike gastric biopsies, is not associated with H. pylori ," she concluded.