What are the differential diagnoses of hematochezia in infants?

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Differential Diagnoses for Bloody Stool in Infants

Single Most Likely Diagnosis

  • Anal Fissure: This is the most common cause of bloody stool in infants, especially in the first few months of life. The blood is usually bright red and seen on the surface of the stool or on the diaper. Anal fissures are small tears in the lining of the anus, often caused by passing hard stools.

Other Likely Diagnoses

  • Allergic Colitis: This condition is caused by an allergic reaction to cow's milk protein or other proteins in the infant's diet. It typically presents with bloody stools, diarrhea, and abdominal pain.
  • Infectious Gastroenteritis: Viral or bacterial infections can cause inflammation of the gut, leading to bloody stools, diarrhea, and vomiting.
  • Intussusception: A condition where a part of the intestine telescopes into another part, causing bowel obstruction and potentially bloody stools.

Do Not Miss Diagnoses

  • Hirschsprung's Disease: A congenital condition characterized by the absence of nerve cells in the colon, leading to severe constipation and potentially bloody stools. If left untreated, it can lead to life-threatening complications.
  • Intestinal Volvulus: A condition where the intestine twists around its mesentery, cutting off blood supply and potentially leading to necrosis. It requires immediate surgical intervention.
  • Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause bleeding, obstruction, or inflammation.

Rare Diagnoses

  • Juvenile Polyposis Syndrome: A rare genetic disorder characterized by the presence of multiple polyps in the gastrointestinal tract, which can cause bleeding and increase the risk of cancer.
  • Congenital Vascular Malformations: Rare conditions where abnormal blood vessels in the gut can cause bleeding and other complications.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis are rare in infants but can cause chronic inflammation, bleeding, and other symptoms.

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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