Differential Diagnosis for an 11-year-old Child with Left Sided Pain
Single Most Likely Diagnosis
- Constipation: This is a common issue in children that can cause left-sided abdominal pain due to the location of the descending colon. The pain is often accompanied by changes in bowel habits.
Other Likely Diagnoses
- Gastroenteritis: Inflammation of the stomach and intestines, usually due to a viral or bacterial infection, can cause left-sided pain, especially if the infection is localized to the left side of the abdomen.
- Functional Abdominal Pain: A condition where abdominal pain is not explained by other medical conditions, often related to stress, anxiety, or changes in bowel habits.
- Left Lower Lobe Pneumonia: Infection in the left lower lobe of the lung can cause referred pain to the left side of the abdomen.
- Urinary Tract Infection (UTI): While more common in girls, UTIs can cause abdominal pain, including on the left side, especially if the infection involves the left kidney.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically causes right lower quadrant pain, in some cases (especially if the appendix is retrocecal), the pain can be more diffuse or on the left side. Missing this diagnosis can lead to severe complications.
- Intussusception: A condition where a part of the intestine slides into another, which can cause severe abdominal pain, often starting around the navel and then moving to the left side. It's a medical emergency.
- Ectopic Pregnancy: Though rare in 11-year-old girls, it's crucial to consider in post-menarchal girls, as it can present with severe left-sided abdominal pain and is life-threatening if not promptly treated.
- Ovarian Torsion: Twisting of the ovary can cause severe, sudden onset of left-sided pain in girls and is a surgical emergency.
Rare Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, including left-sided pain, though they are less common in children.
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain, which might be more pronounced on the left side due to the pancreas's location.
- Sickle Cell Crisis: In children with sickle cell disease, a crisis can cause severe pain episodes, including abdominal pain, which might be localized to one side.
- Abdominal Migraine: A condition that causes recurrent episodes of severe abdominal pain, often accompanied by other migraine symptoms, which can be difficult to diagnose.