Differential Diagnosis for Gastric Bleeding in a Four-Month-Old Infant
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is common in infants and can cause gastric bleeding due to the reflux of stomach acid into the esophagus, leading to irritation and potential bleeding.
Other Likely Diagnoses
- Milk Protein Allergy: An allergy to milk proteins can cause inflammation and bleeding in the gastrointestinal tract of infants.
- Infection (e.g., Helicobacter pylori): Although less common in infants, infections can cause gastric bleeding.
- Swallowed Maternal Blood: Infants may swallow blood during delivery or from cracked nipples during breastfeeding, which can be mistaken for gastric bleeding.
Do Not Miss Diagnoses
- Volvulus or Intussusception: These conditions involve the twisting or telescoping of intestinal segments, which can lead to ischemia and bleeding. They are medical emergencies that require prompt diagnosis and treatment.
- Hemorrhagic Disease of the Newborn: A condition caused by vitamin K deficiency, which can lead to bleeding due to coagulopathy.
- Trauma or Child Abuse: Accidental or non-accidental trauma can cause gastric bleeding and must be considered, especially if other signs of abuse are present.
Rare Diagnoses
- Congenital Anomalies (e.g., gastric duplication, Meckel's diverticulum): These rare conditions can cause gastric bleeding in infants.
- Inherited Coagulopathies (e.g., hemophilia): Although rare, these conditions can cause bleeding due to coagulation factor deficiencies.
- Tumors (e.g., gastric teratoma): Extremely rare in infants, but can cause gastric bleeding if present.