What is the differential diagnosis for left-sided abdominal pain in pediatrics?

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Differential Diagnosis for Left Side Abdominal Pain in Pediatrics

Single Most Likely Diagnosis

  • Constipation: This is a common cause of abdominal pain in children, often presenting with left lower quadrant pain due to the location of the descending colon. The pain can be crampy and may be accompanied by changes in bowel habits.

Other Likely Diagnoses

  • Gastroenteritis: Inflammation of the stomach and intestines, usually due to viral or bacterial infections, can cause abdominal pain that may be localized to the left side, along with symptoms like diarrhea, vomiting, and fever.
  • Functional Abdominal Pain: A condition where abdominal pain is not explained by other medical conditions, often related to stress or bowel habits. The pain can be diffuse or localized, including the left side.
  • Mesenteric Lymphadenitis: Inflammation of the lymph nodes in the mesentery, often due to viral infections, can mimic appendicitis but typically causes left lower quadrant pain.

Do Not Miss Diagnoses

  • Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood supply. It's a surgical emergency that can present with intermittent abdominal pain, often starting around the umbilicus and then localizing, possibly to the left side, along with vomiting and bloody stools.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, including left-sided pain, along with diarrhea, weight loss, and blood in stool.
  • Pneumonia: Basilar pneumonias, especially those involving the left lower lobe, can cause referred pain to the left abdomen due to the shared nerve roots.
  • Ovarian Torsion: In females, twisting of the ovary can cause severe, sudden onset of abdominal pain, often on one side, and is a surgical emergency.

Rare Diagnoses

  • Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause pain, usually in the right lower quadrant but can be variable, along with gastrointestinal bleeding.
  • Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain, often radiating to the back, and is more common in children with certain risk factors like gallstones or genetic conditions.
  • Sickle Cell Crisis: In children with sickle cell disease, a crisis can cause abdominal pain due to vaso-occlusion, which can be diffuse or localized.
  • Henoch-Schönlein Purpura (HSP): A form of vasculitis that can cause abdominal pain, along with a characteristic rash, joint pain, and sometimes kidney involvement.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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