Differential Diagnosis for Lower Abdominal Pain in an 8-Year-Old
Single Most Likely Diagnosis
- Appendicitis: This is a common cause of lower abdominal pain in children, especially around this age. The pain often starts near the belly button and then moves to the lower right abdomen. Vomiting is a common symptom, and while controlled by Zofran, it doesn't rule out appendicitis.
Other Likely Diagnoses
- Gastroenteritis: Inflammation of the stomach and intestines, usually due to a viral or bacterial infection, can cause abdominal pain and vomiting. The fact that vomiting is controlled by Zofran suggests that the nausea component is manageable, but the underlying cause could still be gastroenteritis.
- Constipation: This is a common issue in children that can cause significant abdominal pain. The pain is often crampy and can be accompanied by vomiting, although the vomiting might be less frequent or severe than in other conditions.
- Urinary Tract Infection (UTI): UTIs can cause lower abdominal pain, especially if the infection involves the kidneys (pyelonephritis). Symptoms can include pain, vomiting, and sometimes fever.
Do Not Miss Diagnoses
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood flow. It's a medical emergency that requires prompt treatment. Symptoms include severe abdominal pain, vomiting, and sometimes bloody stools.
- Ectopic Pregnancy: Although extremely rare in an 8-year-old, it's crucial to consider in any female patient with lower abdominal pain, as it can be life-threatening if not promptly diagnosed and treated.
- Ovarian Torsion: This is a condition where the ovary twists around its ligaments, cutting off blood supply. It's rare but can cause severe pain and vomiting, and it requires immediate medical attention.
Rare Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, vomiting, and other symptoms. While not common in children as young as 8, they should be considered if other diagnoses are ruled out and symptoms persist.
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, vomiting, and sometimes bleeding. It's rare and usually presents in early childhood.
- Hernias: Although more common in adults, hernias (like inguinal hernias) can occur in children and cause abdominal pain and vomiting if they become incarcerated or strangulated.