Differential Diagnosis for Pediatric Rectal Bleeding
Single Most Likely Diagnosis
- Anal fissure: This is the most common cause of rectal bleeding in pediatric patients, especially in infants and toddlers. It is often associated with painful defecation and can be caused by constipation, diarrhea, or passing a large stool.
Other Likely Diagnoses
- Gastroenteritis: Infections such as viral or bacterial gastroenteritis can cause rectal bleeding in children, often accompanied by diarrhea, vomiting, and abdominal pain.
- Constipation: Chronic constipation can lead to rectal bleeding due to the passage of hard stools, which can cause anal fissures or rectal prolapse.
- Food allergy or intolerance: Allergic reactions to certain foods, such as cow's milk, can cause rectal bleeding in infants and young children.
- Infectious colitis: Bacterial or viral infections, such as Salmonella or E. coli, can cause inflammation of the colon and lead to rectal bleeding.
Do Not Miss Diagnoses
- Intussusception: A condition where a part of the intestine telescopes into another, which can cause severe abdominal pain, vomiting, and rectal bleeding. It is a medical emergency that requires prompt diagnosis and treatment.
- Meckel's diverticulum: A congenital anomaly of the small intestine that can cause rectal bleeding due to the presence of gastric mucosa, which can lead to ulceration and bleeding.
- Inflammatory bowel disease (IBD): Conditions such as Crohn's disease and ulcerative colitis can cause chronic rectal bleeding, abdominal pain, and diarrhea.
- Abuse or trauma: Rectal bleeding can be a sign of physical abuse or trauma, which requires immediate attention and reporting.
Rare Diagnoses
- Hemolytic-uremic syndrome (HUS): A rare condition that can cause rectal bleeding, kidney failure, and anemia, often associated with E. coli infections.
- Vascular malformations: Rare congenital anomalies of the blood vessels that can cause rectal bleeding.
- Tumors: Rarely, rectal bleeding in children can be caused by tumors such as lymphoma or neuroblastoma.
- Coagulopathy: Bleeding disorders such as hemophilia or von Willebrand disease can cause rectal bleeding, although this is rare in children without a known history of bleeding disorders.