Meckel’s diverticulum, also known as congenital ileal end diverticulum, is most common due to the unclosed intestinal end of the yolk tube. According to anatomical statistics, the incidence in the normal population is 2-4%, more men than women 2 times, most people do not have any symptoms, but 8-22% of cases can occur in a variety of complications, clinical symptoms can occur at any age, of which 48-60% occur within 2 years of age, men have more complications than women 3-4 times. Clinical symptoms] It is generally believed that the presence of intra-diverticular mesenchymal tissue and the morphological characteristics of the diverticulum are important factors causing the complications of Meckle’s diverticulum. (A) Bleeding. About 20-30% of cases, mostly seen in infants within 2 years of age, mainly manifest as painless blood in stool, large amount, up to hundreds of milliliters at a time, bright red or dark red color, hemorrhagic shock and severe anemia in a short period of time. There are no positive signs on abdominal examination. The bleeding often stops on its own, or repeatedly bleeds intermittently. (B) Intestinal obstruction. It accounts for about 25-40% of cases, and may include intussusception, intestinal torsion, intra-abdominal hernia, etc. The intestinal obstruction caused by intestinal hernia and intestinal torsion formed by the fibrous band at the tip of diverticulum, as well as the torsion and adhesion of diverticulum itself is the most common, followed by the ileal intestinal entrapment formed by diverticulum as the starting point, whose clinical manifestations are the same as general intestinal entrapment, strangulated intestinal obstruction or adhesive intestinal obstruction. The onset of the disease is more acute, the symptoms are serious, often strangulated, intestinal necrosis can occur and cause peritonitis. (C) diverticulitis 14-34%. Inflammatory lesions can occur when the diverticulum is poorly drained or when there is foreign body retention. Clinical symptoms are mainly periumbilical or right lower abdominal pain, often accompanied by nausea and vomiting. Abdominal examination may reveal pressure pain and abdominal muscle tension in the right lower abdomen or below the umbilicus, and the symptoms and signs are similar to those of acute appendicitis, which are often difficult to distinguish at the time of diagnosis and are often mistaken for perforated appendicitis and surgery. (D) Diverticular perforation 25 to 50%. Inflammation and ulceration of diverticula can lead to diverticular perforation, most of the sudden onset of symptoms, clinical manifestations of severe abdominal pain, vomiting and fever, abdominal examination with obvious signs of peritoneal irritation. In a few cases, there is free gas under the diaphragm. (V) Others. It can cause diverticular hernia or Litter’s hernia, diverticulum embedded in the inguinal canal hernia sac, causing symptoms of incomplete intestinal obstruction, or painful conical strip masses palpated in the groin only. In addition, there are also foreign bodies or tumors within the diverticulum, which may have diverticulitis symptoms. Pathology】 The diverticulum is located on the ileum within 100 cm from the ileocecal valve, on the opposite edge of the mesentery, with its own blood supply, mostly conical, a few cylindrical, 1 to 2 cm in diameter, the diverticular cavity is narrower than the ileal cavity, between 1 and 10 cm in length, the blind end is free in the abdominal cavity, with occasional residual cords at the top connected to the umbilicus, chest wall or mesentery. The tissue structure is the same as that of ileum, except that the muscular layer is thinner. About 50% of diverticula have vaginal tissues, such as gastric mucosa (80%), pancreatic tissue (5%), jejunal mucosa, duodenal mucosa, colonic mucosa and so on. Continuous sectioning of the diverticula is necessary to detect more miscanthogenic tissues. The gastric mucosa is generally quite widely distributed and can account for most of the diverticular mucosa, sometimes in a scattered islet distribution, but is most easily found near the top of the diverticulum. Pancreatic tissue is often located at the apex and is easily identified as yellowish-white granular. Diverticula can cause ulceration, bleeding and perforation due to the secretion of digestive juices by the superficial tissue and damage to intestinal mucosa; acute inflammation, necrosis and perforation due to fecal mass, foreign body and parasites; various acute intestinal obstruction due to torsion, overlapping, herniation, compression and adhesion. The clinical manifestations of Meckel’s diverticulum and its complications are not specific and are difficult to distinguish from acute appendicitis, appendiceal perforation, intestinal obstruction caused by other etiologies, lower gastrointestinal bleeding, and other diseases. However, when pediatric patients present with these clinical manifestations, the possibility of Meckel’s diverticulum and its complications should be considered. This is especially true when accompanied by umbilical manifestations such as umbilical velvet and umbilical sinus with residual yolk duct. 99mTc-pertechnetate isotope scan for the diagnosis of Meckel’s ear diverticulum has been proven to be a reliable diagnostic method with an accuracy rate of 70-80%. 99mTc has affinity for and can be taken up by the cells of the gastric mucosal lining. Therefore, when the diverticulum wall layer contains gastric mucosa with bleeding cases, the abdominal scan can show the area of radioactive concentration. If meclizine is taken before the examination, it can increase the uptake of gastric mucosa and thus improve the positive rate. However, false negatives may also occur when the gastric mucosa is disrupted by inflammation. In addition, false positives can occur for intestinal hemangiomas, abdominal aortic aneurysms, lymphomas, hydronephrosis, peptic ulcers of the small intestine, intestinal polyps, and small bowel sockets. Therefore, it must also be analyzed and differentiated in the context of what is seen clinically. The newly developed 99mTc-labeled red blood cell abdominal scan examination can detect the site of gastrointestinal bleeding, thus presuming the cause of bleeding and suggesting indications for surgery, which has clinical utility. [Treatment note] All cases with complications of Meckel’s diverticulum should be operated on to remove the diverticulum. In cases presenting with peritonitis or intestinal obstruction, preoperative preparation and surgical exploration should be performed according to the principles of treatment for peritonitis or intestinal obstruction. Cases under 2 years of age that show multiple gastrointestinal bleeding should be operated on after active blood volume replacement. The base of the diverticulum should be wedge-shaped at the time of surgery to avoid leaving behind formed ulcers or fasciculated tissue. If asymptomatic diverticula are found during surgery for other diseases, it used to be thought that if they were in good condition, they could be removed to avoid future problems. In recent years, it is believed that diverticula rarely occur complications, try to avoid unexpected complications caused by the removal of lesionless diverticula. Therefore, it is advocated to not remove as appropriate.