Differential Diagnosis for Kids with Periumbilical Pain

Single Most Likely Diagnosis

• Constipation: This is a common issue in children that can cause periumbilical pain due to the buildup of stool in the intestines, leading to discomfort and pain around the navel area.

Other Likely Diagnoses

• Viral Gastroenteritis: Often presents with abdominal pain, which can be periumbilical, along with vomiting and diarrhea.
• Functional Abdominal Pain: A common condition in children characterized by recurrent abdominal pain not explained by other medical conditions, often related to stress or eating habits.
• Urinary Tract Infection (UTI): Can cause abdominal pain, including periumbilical pain, especially if the infection involves the kidneys.
• Gastroesophageal Reflux Disease (GERD): Though more commonly associated with heartburn, GERD can cause abdominal pain in children.

Do Not Miss Diagnoses

• Appendicitis: Although the pain typically starts periumbilically and then localizes to the right lower quadrant, it's crucial to consider appendicitis due to its potential for serious complications if not promptly treated.
• Intussusception: A condition where a part of the intestine slides into an adjacent part, which can cause severe abdominal pain, vomiting, and bloody stools. It's a medical emergency.
• Midgut Volvulus: A twisting of the intestine that can cut off blood flow, leading to severe pain, vomiting, and potential for intestinal necrosis if not promptly treated.
• Pneumonia: Lower lobe pneumonia can refer pain to the abdomen, including the periumbilical area, especially in young children.

Rare Diagnoses

• Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause pain, bleeding, or obstruction.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can present with chronic abdominal pain, including periumbilical pain, along with changes in bowel habits and weight loss.
• Abdominal Migraine: A condition that presents with recurrent episodes of severe abdominal pain, often periumbilical, accompanied by other migraine symptoms like headache or nausea.

Each of these diagnoses requires careful consideration of the child's overall clinical presentation, including history, physical examination, and potentially, diagnostic tests to determine the underlying cause of the periumbilical pain.