Meckel's diverticulum: using the 'rule of twos,' which statement is correct regarding its clinical presentation?
- A It occurs 2 cm from the ileocecal valve
- B It occurs 2 feet (~60 cm) from the ileocecal valve, affects 2% of the population, is approximately 2 inches long, and presents before age 2 in most symptomatic cases ✓
- C It contains ectopic pancreatic tissue in 2% of cases; the majority contain gastric mucosa
- D It causes 2% of small bowel obstructions and presents as a right-sided mass
Explanation
The 'rule of twos' for Meckel's diverticulum: 2% incidence in the population; 2 feet (approximately 60 cm) proximal to the ileocecal valve (on the antimesenteric border); 2 inches (approximately 5 cm) in length; 2× more common in males; symptomatic in 2% of those with the anomaly; most symptomatic cases present before age 2. Ectopic gastric mucosa (not pancreatic) is the commonest heterotopic tissue (~50%), causing acid-induced bleeding (painless lower GI bleed in children). Technetium-99m pertechnetate scan (Meckel's scan) detects ectopic gastric mucosa. Complications include hemorrhage, intussusception, volvulus, and diverticulitis.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.