A classic presentation of Meckel diverticulum is which?

A classic presentation of Meckel diverticulum is which?

• A. Painless rectal bleeding
• B. Severe abdominal tenderness
• C. Nausea after meals
• D. Chronic diarrhea

Answer: (A)

Meckel diverticulum is a true diverticulum of the ileum that often harbors ectopic gastric tissue. The hallmark presentation, especially in children, is painless lower GI bleeding. The ectopic gastric mucosa can secrete acid, causing ulceration of adjacent ileal mucosa and resulting in painless rectal bleeding that may appear as bright red blood per rectum or melena. The lack of abdominal pain comes from bleeding itself rather than an inflammatory process. In contrast, severe abdominal tenderness would suggest an acute abdomen from complications like obstruction, perforation, or inflammation rather than a simple diverticular bleed. Nausea after meals points to upper GI or gastric pathology, not the bleeding pattern typical of Meckel, and chronic diarrhea has other common etiologies such as inflammatory or malabsorptive conditions.

Meckel diverticulum is a true diverticulum of the ileum that often harbors ectopic gastric tissue. The hallmark presentation, especially in children, is painless lower GI bleeding. The ectopic gastric mucosa can secrete acid, causing ulceration of adjacent ileal mucosa and resulting in painless rectal bleeding that may appear as bright red blood per rectum or melena. The lack of abdominal pain comes from bleeding itself rather than an inflammatory process.

In contrast, severe abdominal tenderness would suggest an acute abdomen from complications like obstruction, perforation, or inflammation rather than a simple diverticular bleed. Nausea after meals points to upper GI or gastric pathology, not the bleeding pattern typical of Meckel, and chronic diarrhea has other common etiologies such as inflammatory or malabsorptive conditions.