Path Image
Mucosa, submucosa and muscularis are all present.

All layers bowel wall are present in Meckel diverticulum, although the serosa is beyond the right image and not seen here.

Focal gastric heterotopia is present, as seen by a few parietal cells.


In the developing embryo, the vitelline duct connects the lumen of the gut to the yolk sac. Failure of this duct to obliterate leads a remnant called Meckel Diverticulum. This blind-ended outpouching of the gut is a true diverticulum, meaning it contains all layers of the bowel wall (Kumar).

The rule of 2s can be used to remember the key points about this vestigial remnant: 2 feet from the ileocecal value, 2 inches in length, 2% are symptomatic, usually presents at age 2 and males are 2 times more likely to be affected.

In approximately half the cases, there will be gastric and/or pancreatic heterotopia. This is an important fact because peptic ulceration can occur in this mucosa and lead to bleeding or symptoms that mimic acute appendicitis.


Although approximately 2% of the population have Meckel Diverticulum, only 5% are symptomatic. The classic presentation is painless rectal bleeding in a young child. In rare cases, perforation and intussusception have been documented (Rabinowitz).


Kumar V, Abbas AK, Fausto N. Robbins and Cotran Pathologic Basis of Disease. 7th Ed. Philadelphia, PA: Elsevier; 2005: 830.

Rabinowitz SS, Hongye Li. eMedicine: Meckel Diverticulum. Last updated on March 18, 2010. Available at:

Last updated: 2010-10-26
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