Differential Diagnosis for Abdominal Pain in Children
Single Most Likely Diagnosis
- Constipation: This is a common issue in children, often presenting with abdominal pain, and can be due to various factors such as diet, hydration, or bowel habits.
- Viral Gastroenteritis: Also known as stomach flu, it's a frequent cause of abdominal pain in children, usually accompanied by vomiting and diarrhea.
Other Likely Diagnoses
- Appendicitis: Although not the most common, it's a significant consideration due to its potential for serious complications if not promptly treated. Symptoms can include pain that initially is diffuse and then localizes to the right lower quadrant.
- Urinary Tract Infection (UTI): Can cause abdominal pain, especially if the infection involves the kidneys. Symptoms might also include dysuria, frequency, and fever.
- Functional Abdominal Pain: Part of functional gastrointestinal disorders, this can include irritable bowel syndrome (IBS), functional dyspepsia, and abdominal migraine, which are common in pediatric populations.
Do Not Miss Diagnoses
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood flow. It's a medical emergency and can present with severe abdominal pain, vomiting, and bloody stools.
- Midgut Volvulus: A twisting of the intestine that can cut off blood flow, requiring immediate surgical intervention. Symptoms can include severe abdominal pain, vomiting, and abdominal distension.
- Pneumonia: Lower lobe pneumonia can refer pain to the abdomen, making it a "do not miss" diagnosis due to its potential severity and the need for prompt antibiotic treatment.
- Diabetic Ketoacidosis (DKA): Can present with abdominal pain, nausea, vomiting, and is a medical emergency requiring immediate treatment to prevent serious complications.
Rare Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis are less common in children but should be considered, especially with chronic abdominal pain, weight loss, and changes in bowel habits.
- Henoch-Schönlein Purpura (HSP): A form of vasculitis that can cause abdominal pain, along with a characteristic rash, joint pain, and sometimes kidney involvement.
- Pancreatitis: Inflammation of the pancreas, which can be due to various causes including gallstones, medications, or systemic diseases. It's rare in children but can cause severe abdominal pain.
- Ovarian Torsion: A gynecological emergency that can cause severe abdominal pain, usually in prepubescent or adolescent girls, and requires immediate surgical intervention.