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Last updated: July 9, 2025View editorial policy

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Differential Diagnosis for a 9-year-old with Vomiting and Abdominal Pain

Single most likely diagnosis

  • Viral Gastroenteritis: This is the most likely diagnosis given the symptoms of vomiting and abdominal pain without fever, and a negative Covid-19 test. The absence of fever and the negative Covid-19 test reduce the likelihood of other infectious causes, making viral gastroenteritis a plausible explanation.

Other Likely diagnoses

  • Constipation: Constipation can cause abdominal pain and vomiting, especially if the constipation is severe. It's a common issue in children and can be easily overlooked.
  • Functional Dyspepsia: This condition is characterized by recurring abdominal pain and vomiting without an identifiable cause. It's a common diagnosis in children with chronic abdominal complaints.
  • Food Poisoning: Although the child has been symptomatic for 5 days, food poisoning could still be a consideration, especially if the child has been consuming the same contaminated food over several days.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

  • Appendicitis: Although the child does not have a fever, appendicitis can present with vomiting and abdominal pain. It's crucial to consider this diagnosis to avoid missing a potentially life-threatening condition.
  • Intussusception: This is a condition where a part of the intestine slides into another, causing bowel obstruction. It's a medical emergency that requires prompt attention.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, vomiting, and other symptoms. Early diagnosis and treatment are essential to manage the disease.

Rare diagnoses

  • Gastric Volvulus: A rare condition where the stomach twists abnormally, causing severe abdominal pain and vomiting.
  • Malrotation with Midgut Volvulus: A congenital condition that can cause intestinal obstruction and ischemia, presenting with abdominal pain and vomiting.
  • Hirschsprung's Disease: A congenital condition affecting the colon, leading to severe constipation, abdominal pain, and vomiting. Although typically diagnosed in infancy, some cases may be diagnosed later in childhood.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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