Differential Diagnosis for Bleeding in Stool of a 7-Month-Old
Single Most Likely Diagnosis
- Anal Fissure: This is a common cause of rectal bleeding in infants, often due to constipation or hard stools causing a tear in the anal mucosa. The age of the child and the nature of the bleeding (usually a streak of blood on the stool surface) support this diagnosis.
Other Likely Diagnoses
- Allergic Colitis: This condition, often associated with cow's milk protein allergy, can cause blood in the stool. It's a consideration in infants who are formula-fed or have recently introduced dairy products.
- Gastroenteritis: Viral or bacterial infections can lead to inflammation of the gastrointestinal tract, resulting in bloody stools. The presence of other symptoms like diarrhea, vomiting, and fever would support this diagnosis.
- Intussusception: Although more commonly associated with abdominal pain and vomiting, intussusception can cause currant jelly stool (a mixture of blood and mucus). It's a significant consideration due to its potential for serious complications if not promptly treated.
Do Not Miss Diagnoses
- Intestinal Intussusception: As mentioned, this condition requires urgent diagnosis and treatment to prevent bowel ischemia and necrosis. It's less common but critical not to miss due to its potential severity.
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause significant bleeding due to the presence of ectopic gastric mucosa. Although rare, it's a critical diagnosis to consider due to the risk of severe blood loss.
- Hirschsprung's Disease: A congenital condition characterized by the absence of ganglion cells in the distal bowel, leading to obstruction and potentially enterocolitis, which can cause bloody stools.
Rare Diagnoses
- Juvenile Polyps: Although rare in infants, these benign growths in the colon can cause intermittent bleeding.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis are rare in infants but can present with bloody stools among other symptoms.
- Vascular Malformations: Rare congenital conditions that can cause bleeding in the gastrointestinal tract, including infantile hemangiomas or other vascular anomalies.