Every once in a while, you’ll find yourself scratching your head in the ER with a child presenting with painless lower GI bleeding and a normal-looking colonoscopy. That’s when your brain better chant the mantra: “Think Meckel.”!
And guess what? It loves the number 2 more than a toddler learning to count. Coincidence? Nah. It’s the diverticulum of twos — and that’s what makes it so easy to remember. Let’s break it down.
Mnemonic: “Rule of 2s” — Meckel’s Diverticulum
| Feature | The Rule of Twos Explanation 📏 |
|---|---|
| Length | ~2 inches long |
| Distance from ileocecal valve | ~2 feet proximal to the ileocecal junction |
| Gender prevalence | 2 times more common in males |
| Prevalence in population | Occurs in ~2% of the population |
| Types of ectopic tissue | Usually 2 types: gastric and pancreatic 🍕+🥞 |
💡 Clarification: The word “di-verticulum” literally starts with “di-” — Greek for “two.” Coincidence? I think not. The ancient anatomists were being witty before it was cool.
🏥 A Case from Khuzdar
A 9-year-old boy from Khuzdar came in with intermittent maroon-colored stools. Dr. Bilal Chaudhary (our pediatrician with a sixth sense for zebra diagnoses) tapped me and said, “No perianal findings. Let’s scan his small bowel.”
Sure enough, a Technetium-99m pertechnetate scan (aka the Meckel scan) picked up ectopic gastric mucosa in a tiny outpouching. You guessed it — Meckel’s diverticulum.
The boy had surgery, bounced back like a champ, and is now living happily with all of his bowel behaving itself.
⚠️ Clinical Pearls (Don’t Miss These!)
- Painless rectal bleeding in a child? Think Meckel until proven otherwise.
- Complications include bleeding, obstruction, diverticulitis, and perforation.
- Often silent until trouble starts — it’s like the appendix’s mischievous cousin.
- It’s a true diverticulum — contains all layers of the bowel wall.
Happy learning, folks! 🙂
