Differential Diagnosis for Right Lower Quadrant/Periumbilical Pain in a 7-Year-Old Female
Single Most Likely Diagnosis
- Appendicitis: This is the most common cause of acute abdominal pain requiring surgical intervention in children. The pain often starts near the umbilicus and then localizes to the right lower quadrant. Appendicitis is more common in children around this age and presents with symptoms such as pain, nausea, vomiting, and fever.
Other Likely Diagnoses
- Constipation: A common issue in children that can cause abdominal pain, which may be perceived in the periumbilical area or lower quadrants.
- Gastroenteritis: Inflammation of the stomach and intestines, usually due to infection, can cause abdominal pain, diarrhea, and vomiting.
- Urinary Tract Infection (UTI): UTIs can cause abdominal pain, especially if the infection involves the kidneys (pyelonephritis). Symptoms may include dysuria, frequency, and flank pain.
- Mesenteric Lymphadenitis: Inflammation of the lymph nodes in the mesentery, often due to viral infections, can mimic appendicitis with abdominal pain and tenderness.
Do Not Miss Diagnoses
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood supply. It's a medical emergency and can present with intermittent abdominal pain, vomiting, and bloody stools.
- Ectopic Pregnancy: Although rare in a 7-year-old, it's crucial to consider in any female patient of childbearing age with abdominal pain, especially if there's a possibility of sexual activity or abuse.
- Ovarian Torsion: Twisting of the ovary, which can cut off its blood supply, is a surgical emergency. It presents with severe, sudden onset of abdominal pain.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, and weight loss.
Rare Diagnoses
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, gastrointestinal bleeding, or obstruction.
- Hernias: Though more common in adults, hernias (like inguinal or umbilical hernias) can occur in children and cause abdominal pain and a palpable mass.
- Pancreatitis: Inflammation of the pancreas, which can be due to various causes including trauma, medications, or genetic conditions, is rare in children but can cause severe abdominal pain.
- Yersinia or Campylobacter Infection: Certain bacterial infections can cause abdominal pain and mimic appendicitis.