Differential Diagnosis for Right Side Pediatric Abdominal Pain
Single Most Likely Diagnosis
- Appendicitis: This is the most common cause of acute abdominal pain in children requiring surgical intervention. The pain often starts around the navel and then moves to the lower right abdomen. Appendicitis is more common in children over 5 years old.
Other Likely Diagnoses
- Constipation: A common cause of abdominal pain in children, which can sometimes be localized to one side.
- Gastroenteritis: Inflammation of the stomach and intestines, usually due to infection, can cause abdominal pain that may be more pronounced on one side.
- Mesenteric Lymphadenitis: Inflammation of the lymph nodes in the mesentery (the tissue that attaches the intestines to the back of the abdominal wall) can mimic appendicitis and cause right-sided abdominal pain.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, which can cause severe abdominal pain, often intermittent and colicky, and may be localized to the right side.
Do Not Miss Diagnoses
- Intestinal Obstruction: Blockage of the intestine can cause severe abdominal pain, vomiting, and constipation. It's a medical emergency.
- Ectopic Pregnancy (in post-pubertal females): Although rare in pediatric populations, it's crucial to consider in sexually active girls as it can present with acute abdominal pain.
- Ovarian Torsion: Twisting of the ovary can cause severe, sudden onset of abdominal pain, often on one side, and is a surgical emergency.
- Pneumonia: Basilar pneumonia can refer pain to the abdomen, and it's essential to consider in the differential diagnosis, especially if there are respiratory symptoms.
Rare Diagnoses
- Meckel's Diverticulitis: Inflammation of a Meckel's diverticulum, a congenital anomaly of the small intestine, can cause abdominal pain, often in the lower abdomen.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, and other symptoms.
- Hepatic or Biliary Disease: Conditions affecting the liver or bile ducts, such as hepatitis or a bile duct stone, can cause right upper quadrant abdominal pain.
- Renal Pathology: Kidney stones or pyelonephritis can cause flank pain that may radiate to the abdomen.