Differential Diagnosis for a 7-year-old with Recurrent Stomach Ache and Vomiting

• Single most likely diagnosis:
  • Viral Gastroenteritis: This is the most likely diagnosis given the recurrent episodes of stomach ache and vomiting, with periods of being fine in between. The pattern of symptoms is consistent with a viral infection that can cause intermittent gastrointestinal upset.
• Other Likely diagnoses:
  • Food Poisoning: Could be a consideration if the child consumed contaminated food or drinks, leading to episodes of vomiting and stomach ache.
  • Functional Gastrointestinal Disorder: Conditions like functional dyspepsia or irritable bowel syndrome could present with recurrent stomach aches and vomiting, especially if triggered by certain foods or stress.
  • Urinary Tract Infection (UTI): Although less common, a UTI can cause abdominal pain and vomiting in children, especially if the infection involves the kidneys.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Appendicitis: Although the intermittent nature of symptoms is atypical, appendicitis can present with recurrent episodes of abdominal pain and vomiting, especially if the appendix is not yet ruptured.
  • Intussusception: A condition where a part of the intestine telescopes into another, causing intermittent abdominal pain and vomiting. It's a surgical emergency if not promptly diagnosed and treated.
  • Diabetic Ketoacidosis (DKA): Can present with abdominal pain and vomiting, and is a medical emergency requiring prompt treatment.
• Rare diagnoses:
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause recurrent abdominal pain and vomiting, but are less common in children and typically have other associated symptoms like diarrhea or weight loss.
  • Cyclic Vomiting Syndrome: A rare condition characterized by recurrent episodes of severe vomiting, often with no apparent cause, and can be associated with abdominal pain.