Differential Diagnosis for a 12-year-old Girl with Lower Abdominal Pain
Single Most Likely Diagnosis
- Functional abdominal pain: This is a common condition in adolescents, characterized by recurrent or persistent abdominal pain that is not explained by other medical conditions. The pain can be related to stress, anxiety, or changes in bowel habits.
Other Likely Diagnoses
- Constipation: A common cause of lower abdominal pain in children, often accompanied by changes in bowel habits, such as infrequent bowel movements or hard stools.
- Urinary Tract Infection (UTI): Bacterial infections of the urinary tract can cause lower abdominal pain, dysuria, and frequent urination.
- Ovarian cysts or torsion: Although less common, ovarian cysts can cause intermittent or constant lower abdominal pain, and torsion is a surgical emergency.
- Gastroenteritis: Inflammation of the stomach and intestines, usually caused by viral or bacterial infections, leading to abdominal pain, diarrhea, and vomiting.
Do Not Miss Diagnoses
- Appendicitis: Although the classic presentation is right lower quadrant pain, appendicitis can sometimes present with lower abdominal pain, and missing this diagnosis can lead to serious complications.
- Ectopic pregnancy: Although rare in 12-year-old girls, it is essential to consider this possibility, especially if there is a history of sexual activity or suspected pregnancy.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, diarrhea, and weight loss.
Rare Diagnoses
- Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, causing chronic pelvic pain, especially during menstruation.
- Ovarian tumors: Benign or malignant tumors of the ovary can cause lower abdominal pain, although they are rare in adolescents.
- Intussusception: A condition where a part of the intestine telescopes into another part, causing severe abdominal pain, vomiting, and bloody stools.