Differential Diagnosis for Generalized Abdominal Pain in a Child
Single Most Likely Diagnosis
- Viral Gastroenteritis: This is the most common cause of generalized abdominal pain in children, often accompanied by symptoms like diarrhea, vomiting, and fever. The high prevalence of viral gastroenteritis in the pediatric population makes it the leading consideration.
Other Likely Diagnoses
- Constipation: A frequent cause of abdominal pain in children, constipation can lead to generalized discomfort due to the accumulation of feces in the intestines.
- Urinary Tract Infection (UTI): While UTIs more commonly present with dysuria and frequency, they can cause abdominal pain, especially if the infection involves the kidneys.
- Functional Abdominal Pain: Also known as functional gastrointestinal disorder, this condition is characterized by recurrent abdominal pain not explained by other medical conditions, often related to stress or eating habits.
Do Not Miss Diagnoses
- Appendicitis: Although less common, appendicitis is a critical diagnosis that must not be missed due to its potential for severe complications, including perforation and peritonitis. Early symptoms can be non-specific, including generalized abdominal pain that may later localize to the right lower quadrant.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, intussusception is a medical emergency that can cause severe abdominal pain, vomiting, and bloody stools. It's more common in younger children.
- Pneumonia: Basilar pneumonia can refer pain to the abdomen, making it a "do not miss" diagnosis, especially if accompanied by respiratory symptoms.
Rare Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, and weight loss. While not as common as other causes, they are important to consider in the differential diagnosis.
- Henoch-Schönlein Purpura (HSP): A systemic vasculitis that can cause abdominal pain, HSP is also associated with a characteristic rash, arthritis, and sometimes kidney involvement.
- Abdominal Migraine: A condition that presents with recurrent episodes of severe abdominal pain, often accompanied by other migraine symptoms like headache and nausea. It's a diagnosis of exclusion and can be challenging to diagnose.