A 12-year-old male is admitted to the hospital with profuse rectal bleeding but appears to be free of any associated pain. Which of the following is the most common cause of severe rectal bleeding in the pediatric age group?

Ileal (Meckel) diverticulum, which is an outpouching of the distal ileum, is twice as prevalent in males as in females. The diverticulum is clinically important because ulceration of the diverticulum with pain, bleeding, perforation, and obstruction is a complication that may require emergent surgery. Signs and symptoms frequently mimic appendicitis or peptic ulcer. Internal hemorrhoids are thrombosed tributaries of the middle rectal vein, which can prolapse into the anal canal. External hemorrhoids are thrombosing in the veins of the external rectal venous plexus. Diverticulosis is ordinarily an outpouching of the wall of the large intestine. This primarily affects the aged and does not cause bleeding in most cases. Borborygmi are sounds created by gas and intestinal contents as they pass through the gastrointestinal tract.