Meckel’s Diverticulum

Meckel’s diverticulum is a congenital anomaly of the gastrointestinal tract resulting from incomplete obliteration of the vitelline (omphalomesenteric) duct during embryonic development. It represents a true diverticulum, containing all layers of the intestinal wall, and is typically located on the antimesenteric border of the ileum, approximately 60–100 cm proximal to the ileocecal valve. It is often described by the “rule of twos” — occurring in about 2% of the population, measuring around 2 inches in length, and commonly presenting before the age of two.

Although frequently asymptomatic, complications may arise due to ectopic gastric or pancreatic mucosa within the diverticulum. Acid secretion from ectopic tissue can cause ulceration and painless lower gastrointestinal bleeding, particularly in children. Other complications include intestinal obstruction, intussusception, inflammation mimicking appendicitis, and perforation.

Diagnosis can be challenging and may involve technetium-99m pertechnetate scintigraphy (Meckel’s scan), ultrasound, CT imaging, or diagnostic laparoscopy. Symptomatic cases require surgical resection, either through diverticulectomy or segmental ileal resection. Prognosis is generally favorable when promptly managed. Early identification is crucial to prevent hemorrhage, obstruction, and other potentially serious outcomes associated with this congenital condition.