Which symptom is associated with Meckel diverticulum?

• A. Constant abdominal pain
• B. Painful hematochezia
• C. Colicky abdominal pain
• D. Painless hematochezia

Answer: (D)

Meckel diverticulum is a remnant of the embryonic omphalomesenteric duct and is often an incidental finding. However, when it becomes symptomatic, one of the most characteristic presentations is painless hematochezia. This occurs due to the presence of ectopic gastric mucosa within the diverticulum, which can secrete acid and lead to ulceration of the adjacent bowel. The resultant bleeding is typically painless, distinguishing it from many other gastrointestinal pathologies that might present with abdominal pain or painful episodes of hematochezia.

Constant abdominal pain, painful hematochezia, and colicky abdominal pain can occur with many other gastrointestinal disorders but are not as specifically associated with Meckel diverticulum. For instance, constant abdominal pain is more typical in bowel obstructions or appendicitis, while painful hematochezia is generally associated with conditions like diverticulitis or hemorrhoids. Colicky abdominal pain is frequently linked to intestinal obstruction or cramping from gastrointestinal conditions but does not neatly fit with the usual presentation of Meckel diverticulum. Thus, the association of painless hematochezia with this diverticulum is a key clinical feature that helps in diagnosis.