Differential Diagnosis for 16yof with Heavy Bleeding

• Single most likely diagnosis
  • Menstrual bleeding or dysfunctional uterine bleeding (DUB): This is the most common cause of heavy bleeding in adolescents, often due to anovulatory cycles.
• Other Likely diagnoses
  • Pregnancy complications (e.g., miscarriage, ectopic pregnancy): Although less common in this age group, pregnancy-related issues can cause heavy bleeding and should be considered.
  • Bleeding disorders (e.g., von Willebrand disease): These conditions can lead to heavy menstrual bleeding and are relatively common in females.
  • Uterine fibroids or polyps: Although less common in adolescents, these conditions can cause heavy bleeding and should be considered.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Ectopic pregnancy: Although less common, ectopic pregnancy can be life-threatening if not promptly diagnosed and treated.
  • Uterine rupture or perforation: Rare but potentially life-threatening conditions that require immediate attention.
  • Severe bleeding disorders (e.g., hemophilia): Although rare in females, these conditions can lead to severe bleeding and should not be missed.
• Rare diagnoses
  • Reproductive tract tumors (e.g., cervical or uterine cancer): These conditions are rare in adolescents but can cause heavy bleeding and should be considered if other diagnoses are ruled out.
  • Inherited bleeding disorders (e.g., factor deficiencies): Rare conditions that can cause heavy bleeding and should be considered if other diagnoses are ruled out.
  • Arteriovenous malformations (AVMs): Rare vascular anomalies that can cause heavy bleeding and should be considered if other diagnoses are ruled out.