LAUSR

We acknowledge the observations and comments by Yagnik and Yagnik on the article by Teng et al. with great interest. Authors had circumstantially described the ‘Rule of 2’ in relation to Meckel’s diverticulitis (MD) namely the incidence of 2%, more commonly symptomatic under the age of 2 years, 2 inches in length, 2 cm in diameter, 2 ft proximal to the ileocaecal valve, presence of dual ectopic mucosal tissues, twice more common in males and more symptomatic in 2% of patients. In addition to the extensive list, the authors had suggested the addition of another feature which is the position of MD, either at the anti-mesenteric (which is traditionally located) or mesenteric border. MD always happens on the anti-mesenteric side of the ileum due to its direct communication with the yolk sac during embryological life. However, the literature has suggested that MD can be originated from the mesenteric side as well because of various postulations. We welcome another addition of unusual characteristic of MD to the current list of rule of 2 with an openhandedness. However, bear in mind that the list is just for academic purpose as majority of the cases even are not fulfilling the rule of 2. At the end of the day, when it comes to the management of MD, reality overrules the postulation. We do agree that surgical treatment of MD is controversial. Yagnik et al. had extensively described the conclusion of a meta-analysis by Zani et al. on the resection of incidentally found MD. However, we want to stress that our patient presented with gangrenous MD, which is deemed for resection. Failure to do so will lead to indisputable complications such as perforation, peritonitis, septic shock and even mortality.