Differential Diagnosis for a 14-month-old Girl with Intermittent Vomiting and Bloody Stool
- Single most likely diagnosis
- C) Intussusception: This condition is characterized by the telescoping of one portion of the intestine into another, leading to intermittent abdominal pain, vomiting, and bloody stools. The age of the patient and the presence of bloody stool without abdominal distention or evidence of bowel obstruction on the x-ray make intussusception a strong candidate for the diagnosis.
- Other Likely diagnoses
- D) Viral gastroenteritis: Although viral gastroenteritis can cause vomiting and diarrhea, the presence of blood in the stool is less common but can occur. The lack of abdominal distention and the absence of bowel obstruction signs on the x-ray do not rule out this diagnosis.
- B) Dysentery: Dysentery, often caused by bacterial infections like Shigella, can lead to bloody diarrhea, abdominal pain, and vomiting. However, it might not fully explain the intermittent pattern of symptoms described.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- A) Appendicitis: Although less common in this age group and the presentation is not typical (appendicitis usually presents with more constant pain and tenderness), appendicitis can lead to severe consequences if not promptly diagnosed and treated.
- E) Volvulus: A volvulus is a twisting of a portion of the intestine that can cut off blood flow and lead to tissue death. It is a surgical emergency and can present with vomiting, abdominal pain, and bloody stools. The absence of abdominal distention and bowel obstruction signs on the x-ray does not rule out this condition.
- Rare diagnoses
- Other rare conditions such as Meckel's diverticulum, intestinal polyps, or vascular malformations could also present with similar symptoms but are less likely given the clinical presentation and age of the patient. These would be considered if more common diagnoses are ruled out.