<prompt> Which of the following is not a feature of meckels diverticulum -It is a remanant of vitellointestinal ductIt is found on the mesenteric side of the ileumIt may contain heterotopic epithelium of the gastric, colonic or pancreatic typeMeckels diverticulum in inguinal or femoral hernia is described as Littres hernia  <response>: Ans. is b i.e., It is found on the mesenteric side of the ileum Meckels diverticulum: A Meckels diverticulum is a persistent remnant of the vitellointestinal duct and is present in about 2 per cent of the population. It is found on the antimesenteric side of the ileum, commonly at 60 cm from the ileocaecal valve and is classically 5 cm long. A Meckels diverticulum contains all three coats of the bowel wall and has its own blood supply. It is vulnerable to obstruction and inflammation in the same way as the appendix; indeed, when a normal appendix is found at surgery for suspected appendicitis, a Meckels diverticulum should be looked for by examining the small bowel particularly if free fluid or pus is found. In around 20 per cent of cases, the mucosa of a MeckeVs diverticulum contains heterotopic epithelium of gastric, colonic or pancreatic type. A Meckels diverticulum can present clinically in the following ways:i Haemorrhage: If gastric mucosa is present, peptic ulceration can occur and present as painless maroon rectal bleeding or melaena. If the stomach, duodenum and colon are cleared by endoscopy, radioisotope scanning with technetium-99m may demonstrate a Meckels. A Meckels is notoriously difficult to see with contrast radiology.ii Diverticulitis: Meckels diverticulitis presents like appendicitis, although if perforation occurs the presentation may resemble a perforated duodenal ulcer.iii Intussusception: A Meckels can be the lead point for ileoileal or ileocolic intussusception.iv Chronic ulceration: Pain is felt around the umbilicus, as the site of the diverticulum is midgut in origin.v Intestinal obstruction: A band between the apex of the diverticulum and the umbilicus also part of the vitellointestinal duct may cause obstruction directly or by a volvulus around it.vi Perforation The vast majority of Meckels are asymptomatic. When found in the course of abdominal surgery, a Meckels can safely be left alone provided it has a wide mouth and is not thickened. When there is doubt, it can be resected. The finding of a Meckels diverticulum in an inguinal or femoral hernia has been described as Littres hernia. 