Meckel’s Diverticulum : Rule of 2

General description

  • Most common congenital abnormality of gastrointestinal tract
  • Occurs due to incomplete obliteration of omphalomesenteric duct in the 7th week of gestation
  • True diverticulum (presence of all layers of small bowel wall)
  • Develop from anti-mesenteric surface of the mid-distal ileum
meckels diverticulum
“This image is taken from Page 28 of Contribution a la pathologie du diverticule de Meckel” by Medical Heritage Library, Inc. is licensed under CC BY-NC-SA 2.0.

Rule of 2s

1. Occurs in 2% population

2. Symptomatic cases are 2 times more common in males

3. Located within 2 feet proximal to ileocecal valve

4. 2 inches long and 2 cm diameter

5. 2 types of ectopic mucosa: gastric and pancreatic

  • Meckel’s scan (Tc99m) identifies gastric mucosa

6. Symptomatic only in 2% adults

  • Meckel’s diverticulitis
  • Gastrointestinal hemorrhage
  • Small bowel obstruction

7. Usually symptomatic before 2 years age

8. 2 types of surgery:

  • Long diverticula (height to diameter ratio >2): Diverticulectomy
    • If inflamed/perforated base or complicated obstruction: Wedge or segmental resection
  • Short diverticula (height to diameter ratio <2): Wedge or segmental resection

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