Differential Diagnosis for Left Iliac Fossa Tenderness in a Male Child
Single Most Likely Diagnosis
- Constipation: This is a common issue in children that can cause left iliac fossa tenderness due to the accumulation of feces in the sigmoid colon, which is located in this area.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): A functional gastrointestinal disorder that can cause abdominal pain, including in the left iliac fossa, due to altered bowel habits and sensitivity.
- Gastroenteritis: Inflammation of the gastrointestinal tract, usually due to infection, which can cause abdominal pain, including in the left lower quadrant.
- Mesenteric Lymphadenitis: Inflammation of the lymph nodes in the mesentery, often due to viral infections, which can mimic appendicitis but is located more in the left lower quadrant.
Do Not Miss Diagnoses
- Intussusception: A condition where a part of the intestine telescopes into another part, which is a medical emergency and can cause severe abdominal pain, including in the left iliac fossa.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic inflammation of the gastrointestinal tract, leading to abdominal pain, including in the left lower quadrant.
- Testicular Torsion: Although the primary symptom is testicular pain, it can sometimes refer pain to the lower abdomen, including the left iliac fossa, and is a surgical emergency.
- Appendicitis: Although appendicitis typically causes pain in the right lower quadrant, in some cases (especially if the appendix is retrocecal), the pain can be more diffuse or even localized to the left lower quadrant.
Rare Diagnoses
- Diverticulitis: Inflammation of a diverticulum in the colon, which is rare in children but can cause left lower quadrant pain if the diverticulum is in the sigmoid colon.
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause bleeding, obstruction, or inflammation, leading to abdominal pain, including in the left lower quadrant.
- Ovarian Torsion: Although this condition is more common in females, it can occasionally occur in males with undescended testes or other anatomical abnormalities, causing severe abdominal pain.