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.