A 2-year-old boy presents with painless bright red rectal bleeding. Haemoglobin is 8 g/dL and the abdomen is soft. A technetium-99m pertechnetate scan shows a focal area of uptake in the right lower quadrant synchronous with gastric mucosa. Which statement about the underlying lesion is correct?

• A It lies within 50 cm of the ileocaecal valve in most cases
• B It contains heterotopic pancreatic tissue in about 60 percent of symptomatic children
• C It arises from persistence of the vitellointestinal duct and may lie up to 100 cm from the ileocaecal valve ✓
• D It is lined entirely by colonic epithelium

Explanation

Meckel diverticulum results from failure of obliteration of the vitellointestinal duct. The rule of twos applies: it occurs in about 2 percent of the population, is roughly 2 inches long, lies within 2 feet (about 60 cm) of the ileocaecal valve, and commonly contains two types of heterotopic mucosa, gastric being the most frequent. Painless lower gastrointestinal bleeding comes from acid secretion by heterotopic gastric mucosa, which the pertechnetate scan detects.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.