<prompt> Meckels diverticulum all is true except-It contains all layersRemanent of urachal cystHeterotopic epithelium in 50-60 casesMay present with hemorrhage  <response>: Ans. is b i.e., Remanent of urachal cystMeckels diverticulum is situated at the anti-mesenteric border of small intestine,o MeckelS diverticulum is a true diverticulum as it has all the 3 layers of the intestine,o It s the most common congenital anomaly of the gastrointestinal tract,o Male to female ratio is 3 :2.o Approximately 60 of Meckel s diverticula contain heterotopic mucosa, of which more than 60 consists of gastric mucosa. Second most common ectopic mucosa is that of Pancreas Pancreatic acini. Other mucosa are - colonic mucosa, Brunners gland, pancreatic islets, endometriosis and hepatobiliary tissue,o A useful but crude Mnemonic used traditionally for describing Meckels diverticula isRule of two : i.e.2 prevalence2 inch in length2 feet proximal to ileocecal valve.Half of these who are symptomatic are younger than 2 yrs of ageo Meckels diverticula are asymptomatic. Symptoms arise only when any complication occurs.o Complicationso Most common complication In children young adults 18 yrs of age-bleeding In adults-intestinal obstruction Overall-bleedingo Following complications are noted in Meckels diverticulum.BleedingBleeding in Meckels diverticulum is usually the result of ulceration in ileal mucosa adjacent to the diverticulum caused by the acid secreted by heterotopic gastric mucosa within the diverticulum.Intestinal obstructionIntestinal obstruction associated with Meckels diverticulum can result from several mechanisms.Volvulus of the intestine around the fibrous band attaching the diverticulum to the umbilicusIntussusception with the diverticulum acting as the lead point.Entrapment of intestine by a mesodiverticuiar band Mesodiverticular band is a remnant of left vitelline artery, it tethers the Meckels diverticulum to the ileal mesentry.d Stricture secondary to chronic diverticulitis.3 DiverticulitisClinical picture is similar to appendicitis.Diverticulitis may lead to perforation.o Littres hernia -Rarely Meckels diverticulum is found in inguinal or femoral hernia. This is known as Littres hernia.o Diagnostic studiesMeekers diverticulum in the absence of bleeding can be rarely diagnosed before surgical intervention.Barium meal follow through can rarely demonstrate the diverticulum. Barium enteroclysis can demonstrate the diverticula in 75 of cases but is avoided during acute presentation of complication.If repeated episodes of lower GI bleed occur and an ectopic gastric mucosa in the Meckels diverticulum is suspected, it can be demonstrated by Technetiumtmpertechnate radionuclide scan. It demonstrates the ectopic gastric mucosa and localizes the Meckels diverticulum. Angiography can localize the site of bleeding during acute hemorrhage related to meckels diverticula. 