Differential Diagnosis for Stomach Pain and Headache in a Pediatric Patient

Single Most Likely Diagnosis

• Functional gastrointestinal disorder: This is a common cause of stomach pain in pediatric patients, and headaches can be associated with gastrointestinal issues due to stress, anxiety, or referred pain. The chronic nature of the symptoms over 2 weeks supports this diagnosis.

Other Likely Diagnoses

• Viral gastroenteritis: Although typically presenting with diarrhea and vomiting, some viral infections can cause stomach pain and headache without prominent gastrointestinal symptoms.
• Constipation: A common issue in pediatric patients that can cause abdominal pain and potentially headaches due to discomfort or straining during bowel movements.
• Stress or anxiety-related disorders: These can manifest as both stomach pain and headaches in children, especially if they are experiencing school or social pressures.

Do Not Miss Diagnoses

• Appendicitis: Although less likely given the duration of symptoms, appendicitis can present atypically in children, and missing this diagnosis can have severe consequences.
• Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain and may be associated with headaches due to systemic inflammation.
• Meningitis or encephalitis: Infections that can cause severe headache and, less commonly, abdominal pain. These conditions are medical emergencies.
• Kidney stones or urinary tract infections: Can cause severe abdominal pain and headache, especially if the infection spreads to the kidneys.

Rare Diagnoses

• Mitochondrial disorders: Rare genetic conditions that can affect energy production in cells, leading to a variety of symptoms including abdominal pain and headaches.
• Ehlers-Danlos syndrome: A group of disorders that affect connective tissues, which can lead to gastrointestinal issues and headaches among other symptoms.
• Porphyrias: A group of rare disorders that can cause abdominal pain, neurological symptoms, and sometimes headaches due to the accumulation of porphyrins.

Each of these diagnoses should be considered in the context of the patient's full clinical presentation, including any additional symptoms, physical examination findings, and diagnostic test results.