Meckel's diverticulum is a congenital diverticulum of the small intestine. It is a remnant of the omphalomesenteric duct (also called the vitellointestinal duct) and contains ectopic ileal, gastric or pancreatic mucosa

Rule of 2's
  • occurs in 2% of the population
  • is 2 feet from the ileocaecal valve
  • is 2 inches long


  • Incidence: 15.00 cases per 100,000 person-years
  • Peak incidence: 1-5 years
  • Sex ratio: more common in males 2:1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+


  • normally, in the foetus, there is an attachment between the vitellointestinal duct and the yolk sac. This disappears at 6 weeks gestation
  • the tip is free in the majority of cases
  • associated with enterocystomas, umbilical sinuses, and omphaloileal fistulas.
  • arterial supply: omphalomesenteric artery.
  • typically lined by ileal mucosa but ectopic gastric mucosa can occur, with the risk of peptic ulceration. Pancreatic and jejunal mucosa can also occur.

Clinical features

Presentation (usually asymptomatic)
  • abdominal pain mimicking appendicitis
  • rectal bleeding
    • Meckel's diverticulum is the most common cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years
  • intestinal obstruction
    • secondary to an omphalomesenteric band (most commonly), volvulus and intussusception


  • removal if narrow neck or symptomatic. Options are between wedge excision or formal small bowel resection and anastomosis.