Differential Diagnosis for Abdominal Pain in Pediatrics

Single Most Likely Diagnosis

• Constipation: This is a common cause of abdominal pain in children, often due to dietary factors, dehydration, or poor bowel habits. It's characterized by infrequent bowel movements, hard stools, and sometimes blood in the stool.

Other Likely Diagnoses

• Viral Gastroenteritis: Commonly known as the stomach flu, it leads to abdominal pain, diarrhea, vomiting, and fever. It's highly contagious and often spread through close contact with an infected person.
• Urinary Tract Infection (UTI): UTIs can cause abdominal pain, especially in the lower abdomen, along with symptoms like dysuria, frequent urination, and fever.
• Functional Abdominal Pain: A condition where abdominal pain is not explained by other medical conditions, often related to stress, anxiety, or changes in bowel habits.

Do Not Miss Diagnoses

• Appendicitis: Although less common, appendicitis is a medical emergency that requires prompt surgical intervention. Symptoms include severe abdominal pain that may start around the navel and then moves to the lower right abdomen, fever, and vomiting.
• Intussusception: A condition where a part of the intestine slides into an adjacent part, leading to bowel obstruction. It's characterized by severe abdominal pain, vomiting, and bloody stools.
• Pyloric Stenosis: A condition that affects infants, causing the muscle around the pylorus to thicken, leading to projectile vomiting and abdominal pain.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, weight loss, and fatigue.

Rare Diagnoses

• Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, gastrointestinal bleeding, and intestinal obstruction.
• Hirschsprung's Disease: A condition affecting the large intestine, leading to severe constipation or intestinal obstruction, often diagnosed in infancy.
• Abdominal Migraine: A condition that causes recurrent episodes of abdominal pain, often accompanied by other migraine symptoms like headache and nausea.

Each of these diagnoses requires careful consideration of the child's symptoms, medical history, and physical examination findings, along with appropriate diagnostic tests to determine the underlying cause of abdominal pain.