Differential Diagnosis for 8-year-old with Left Upper Abdominal Pain
Single Most Likely Diagnosis
- Constipation: This is a common issue in children that can cause abdominal pain, especially if the child is not having regular bowel movements. The pain can be severe and recurrent, fitting the description provided.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause abdominal pain, especially in the upper abdomen, and can be exacerbated by eating or lying down. It's a common condition in children and could explain the recurrent pain.
- Functional Abdominal Pain: This is a condition where abdominal pain occurs without any identifiable cause. It's common in children and can be related to stress, eating habits, or other non-organic factors.
- Urinary Tract Infection (UTI): Although UTIs more commonly cause lower abdominal pain, they can sometimes cause upper abdominal pain, especially if the infection involves the kidneys.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically causes right lower quadrant pain, it can occasionally cause upper abdominal pain, especially if the appendix is located in an atypical position. Missing appendicitis can lead to serious complications.
- Pneumonia: Basilar pneumonia can cause upper abdominal pain due to referred pain from the diaphragm. This is a critical diagnosis not to miss, as pneumonia can be serious in children.
- Intussusception: This is a condition where a part of the intestine telescopes into another part, causing bowel obstruction. It's a medical emergency and can cause severe abdominal pain.
- Pancreatitis: Although rare in children, pancreatitis can cause severe upper abdominal pain and is a diagnosis that should not be missed due to its potential for serious complications.
Rare Diagnoses
- Hepatic or Splenic Cysts: These are rare conditions that can cause upper abdominal pain, usually due to rupture or bleeding into the cyst.
- Gastric or Duodenal Ulcers: Peptic ulcers can cause severe upper abdominal pain and are more common in adults but can occur in children, especially those with a family history of ulcers or using NSAIDs.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, diarrhea, and other symptoms. They are less common in children but should be considered in the differential diagnosis of chronic abdominal pain.