Differential Diagnosis for a 7-year-old boy with abdominal pain
- Single most likely diagnosis
- B) Functional abdominal pain: This is the most likely diagnosis given the patient's symptoms of recurrent, non-specific abdominal pain without other alarming signs such as vomiting, diarrhea, bloody stools, or weight loss. The pain occurs at a predictable time (before bedtime) and does not seem to interfere significantly with the child's daily activities or growth.
- Other Likely diagnoses
- A) Constipation: Although the patient has daily bowel movements, constipation can sometimes present with abdominal pain, especially if the stools are hard or the child is straining during bowel movements. However, the absence of other typical symptoms of constipation (e.g., hard stools, straining, or fewer than three bowel movements per week) makes this less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- D) Inflammatory bowel disease: While less common, inflammatory bowel disease (IBD) can present with chronic abdominal pain and should be considered, especially if there are other symptoms such as weight loss, diarrhea, or bloody stools, which are not present in this case.
- E) Peptic ulcer disease: Although rare in children, peptic ulcer disease can cause abdominal pain and should be considered, especially if the pain is localized to the epigastric region and worsens with food intake.
- Rare diagnoses
- C) Gastritis: Gastritis is less common in children without a clear cause (e.g., NSAID use, infection) and typically presents with more acute symptoms such as nausea, vomiting, and epigastric pain, making it a less likely diagnosis in this scenario.