Peyer's patches are oval clusters of lymphoid follicles in the wall of the small intestine, most numerous and largest in the ileum. They lie on the side of the bowel opposite the mesentery. Specialised M cells in the overlying lining pass gut contents to the immune cells beneath, so the patches act as the immune system's sampling stations for the intestine.
| Location | Mucosa and submucosa of the small intestine, especially the distal ileum, on the antimesenteric border |
|---|---|
| Secretes |
|
| Blood Supply | Ileal branches of the superior mesenteric artery |
| Lymphatic drainage |
|
Monitor intestinal contents and generate IgA-producing B cells and regulatory responses that protect against gut pathogens while tolerating food and normal gut bacteria.
Peyer's patches are the entry point for Salmonella typhi, and in typhoid fever they can ulcerate and perforate. Enlarged lymphoid tissue in the terminal ileum can act as the lead point for intussusception in young children. They are also an early site of involvement in Crohn disease and a route by which prions enter after ingestion.
Ulceration of infected Peyer's patches in the ileum during typhoid fever, which can perforate and cause peritonitis.
Telescoping of bowel, in children often at the ileocaecal junction with enlarged lymphoid tissue as the lead point, causing colicky pain and bloody stools.
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