Surgery · Pediatric Surgery

A 3-year-old boy presents with painless lower gastrointestinal bleeding. A technetium-99m pertechnetate scan shows a focal area of uptake in the right lower quadrant appearing simultaneously with gastric mucosa. Which feature of the underlying lesion follows the classical 'rule of 2s' incorrectly stated below?

  • A Occurs in approximately 2% of the population
  • B Is usually symptomatic before 2 years of age
  • C Contains ectopic tissue in about 20% of cases
  • D Is usually located within 2 feet of the ileocaecal valve
Correct answer: C. Contains ectopic tissue in about 20% of cases

Explanation

Meckel diverticulum follows the rule of 2s: present in about 2% of people, usually 2 inches long, within 2 feet of the ileocaecal valve, symptomatic mostly under 2 years, and containing ectopic mucosa in roughly half of symptomatic cases, far more than 20%. Ectopic gastric mucosa secretes acid, causing ulceration and painless bleeding, which the pertechnetate scan detects because it is taken up by gastric parietal cells.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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