Differential Diagnosis for Intermittent Abdominal Pain in a 4-Year-Old
Single Most Likely Diagnosis
- Viral Gastroenteritis: This is the most common cause of abdominal pain, vomiting, and diarrhea in children. The symptoms presented, such as intermittent abdominal pain, vomiting, and diarrhea, are classic for viral gastroenteritis, which is highly contagious and often seen in pediatric populations.
Other Likely Diagnoses
- Constipation: Although less likely given the presence of diarrhea, constipation can cause intermittent abdominal pain and vomiting in children. The pain can be severe and may lead to vomiting.
- Urinary Tract Infection (UTI): UTIs can present with abdominal pain, vomiting, and sometimes diarrhea in children. The diagnosis should be considered, especially if there are other symptoms like dysuria or fever.
- Food Poisoning: Similar to viral gastroenteritis, food poisoning can cause sudden onset of vomiting, diarrhea, and abdominal pain after consuming contaminated food or drinks.
Do Not Miss Diagnoses
- Appendicitis: Although less common in young children, appendicitis is a surgical emergency that can present with abdominal pain, vomiting, and sometimes diarrhea. It's crucial to consider this diagnosis to avoid missing a potential surgical emergency.
- Intussusception: This is a condition where a part of the intestine slides into an adjacent part, leading to bowel obstruction. It's a medical emergency that can cause severe abdominal pain, vomiting, and sometimes currant jelly stool (a mixture of blood and mucus).
- Pyloric Stenosis: Typically presents in infants but can occasionally be seen in older children, pyloric stenosis causes projectile vomiting and can lead to abdominal pain and dehydration if not treated promptly.
Rare Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis are rare in young children but can cause chronic abdominal pain, diarrhea, and vomiting.
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, vomiting, and gastrointestinal bleeding, although it's more commonly associated with painless bleeding.
- Henoch-Schönlein Purpura (HSP): A systemic vasculitis that can cause abdominal pain, vomiting, and sometimes gastrointestinal bleeding, along with the characteristic purpuric rash.