[Verse 1] Embryology lecture, pay attention to the gut Vitelline duct should vanish but sometimes it stays shut Obliteration fails around week seven, eight A fibrous cord, a fistula, or a diverticulum waits True diverticulum — all three layers of the wall Antimesenteric border, ileum gets the call Two percent of the population carry it around Most completely silent, never making any sound [Chorus] Rule of twos, let it fuse into your memory tight Two percent prevalence, two years is the age of bite Two inches long, two feet from the ileocaecal valve Two types of tissue hiding — gastric, pancreatic halves Symptomatic in two percent — that's the fraction that ignites Rule of twos, rule of twos, carve the numbers in tonight [Verse 2] Heterotopic mucosa — gastric lining out of place Acid secreting, ulcerating at the base Painless rectal bleeding in a toddler, classic sign Technetium pertechnetate scan traces the gastric line Meckel's scan lights up the ectopic gastric gland Sensitivity jumps with pentagastrin, understand Adults present differently — obstruction, intussusception Diverticulitis mimics the appendix in its inflection Perforation, volvulus around a fibrous band The spectrum broad, the surgeon needs a disciplined hand [Chorus] Rule of twos, let it fuse into your memory tight Two percent prevalence, two years is the age of bite Two inches long, two feet from the ileocaecal valve Two types of tissue hiding — gastric, pancreatic halves Symptomatic in two percent — that's the fraction that ignites Rule of twos, rule of twos, carve the numbers in tonight [Verse 3] Diverticulectomy — wedge it at the base Ensure no heterotopic tissue lingers in that space Narrow neck, inflamed, or ectopic mucosa found Segmental resection with anastomosis, safe and sound Primary anastomosis, end to end, restore the flow Stapled or hand-sewn depending on the field below Laparoscopic approach is feasible and clean Inspect the mesodiverticular band when laparoscope is keen [Bridge] Now incidental Meckel's — the contested conversation Discovered during laparotomy for another indication In a child, resect it — the calculus is plain Heterotopic tissue, narrow neck, a fibrous band attained Adults asymptomatic — the risk of intervention May actually exceed the lifetime complication tension Anomalous remnants — omphalomesenteric fistula draining umbilical Umbilical polyp, sinus tract, the congenital umbilical Persistent vitelline remnants — vestigial, vermicular A word for something rudimentary — obsolete but particular [Chorus] Rule of twos, let it fuse into your memory tight Two percent prevalence, two years is the age of bite Two inches long, two feet from the ileocaecal valve Two types of tissue hiding — gastric, pancreatic halves Symptomatic in two percent — that's the fraction that ignites Rule of twos, rule of twos, carve the numbers in tonight
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