Differential Diagnosis for 14M with Lower Abdominal Pain
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The pain started when urinating, which suggests a possible infection in the urinary tract. UTIs are common in adolescents and can cause lower abdominal pain, especially during urination (dysuria).
Other Likely Diagnoses
- Kidney Stone: Although less common in adolescents, kidney stones can cause severe pain, often radiating to the lower abdomen, and can be associated with urination symptoms.
- Prostatitis: Inflammation of the prostate gland can cause lower abdominal pain, pain during urination, and other urinary symptoms.
- Epididymitis: Inflammation of the epididymis, often due to infection, can cause pain in the lower abdomen that may radiate to the testicles.
Do Not Miss Diagnoses
- Testicular Torsion: A medical emergency that requires immediate attention. It can cause severe lower abdominal pain and is often associated with a sudden onset of pain, nausea, and vomiting.
- Appendicitis: Although the pain typically starts near the navel and then moves to the lower right abdomen, atypical presentations can occur, especially in younger patients.
- Pyelonephritis: An infection of the kidney that can cause severe pain, fever, and other systemic symptoms. It's crucial to diagnose and treat promptly to avoid complications.
Rare Diagnoses
- Henoch-Schönlein Purpura (HSP): A systemic vasculitis that can cause abdominal pain, among other symptoms like rash and joint pain. It's rare but should be considered in the differential diagnosis.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, including in the lower abdomen, but are less likely to present acutely with pain during urination.