A 13yo boy with umbilical pain for the last 12h presents with  anorexia, nausea and has not passed a bowel motion 24h. What is your dx?
 
a. Acute appendicitis
b. IBD
c. IBS
d. Meckel’s diverticulum
e. Muscle strain
f. Ovarian cysts
g. PID
h. Psoas hematoma
i. Pyelonephritis
j. Uretric calculus 
answer: D
Although Meckel diverticulum is usually of no medical significance, two  types of complications can require clinical attention. One type involves  ectopic mucosal tissue and most often leads to GI bleeding in younger  children. In the second type, the sequelae lead to an obstruction,  inflammation, or rarely perforation of the bowel.
The classic presentation in children <2years is considered to be painless rectal bleeding. In adults and older children, obstruction and inflammation are more common presentations than lower GI bleeding.
