Differential Diagnosis for 11 YO with Left Side Abdominal Pain
- Single most likely diagnosis:
- Constipation: The patient's symptoms of abdominal pain that comes and goes, worsens when lying on the left side, and has a history of stomach issues and normal bowel movements could be indicative of constipation. The emesis could be related to the constipation or other gastrointestinal issues.
- Other Likely diagnoses:
- Gastroesophageal reflux disease (GERD): The patient's history of stomach issues and emesis could be related to GERD, which is a common condition in children.
- Irritable bowel syndrome (IBS): The patient's abdominal pain, changes in bowel movements, and emesis could be indicative of IBS.
- Inflammatory bowel disease (IBD): Although less common, the patient's symptoms could be related to IBD, such as Crohn's disease or ulcerative colitis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Appendicitis: Although the pain is on the left side, appendicitis can present with atypical symptoms, and missing this diagnosis could be life-threatening.
- Intussusception: This is a rare condition where the intestine telescopes into itself, causing severe abdominal pain and potentially life-threatening complications if not treated promptly.
- Ectopic pregnancy (in post-pubertal females): Although unlikely, it's essential to consider ectopic pregnancy in post-pubertal females with abdominal pain, especially if there's a possibility of sexual activity.
- Rare diagnoses:
- Malrotation with volvulus: This is a rare condition where the intestine twists, causing severe abdominal pain and potentially life-threatening complications.
- Meckel's diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, bleeding, or obstruction.
- Chronic intestinal pseudo-obstruction: A rare condition characterized by recurrent episodes of abdominal pain, nausea, and vomiting due to impaired intestinal motility.