Differential Diagnosis for Pediatric Abdominal Pain
Single Most Likely Diagnosis
- Constipation: This is a common cause of abdominal pain in children, often due to a low-fiber diet, dehydration, or poor bowel habits. The pain is usually intermittent and accompanied by changes in bowel movements.
Other Likely Diagnoses
- Viral Gastroenteritis: A frequent cause of abdominal pain in children, characterized by diarrhea, vomiting, and fever. It's often self-limiting but can lead to dehydration.
- Functional Abdominal Pain: Also known as irritable bowel syndrome (IBS) in some cases, this condition is characterized by chronic or recurrent abdominal pain without an identifiable cause. It's often associated with changes in bowel habits or relieved by defecation.
- Urinary Tract Infection (UTI): Can cause abdominal pain, especially if the infection involves the kidneys (pyelonephritis). Symptoms may include dysuria, frequency, and fever.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, weight loss, and blood in the stool.
Do Not Miss Diagnoses
- Appendicitis: Although less common, appendicitis is a critical diagnosis to consider due to the risk of perforation and peritonitis. Symptoms include severe abdominal pain (often starting around the navel and then moving to the lower right abdomen), fever, and vomiting.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood flow. It's an emergency and presents with severe abdominal pain, vomiting, and sometimes bloody stools.
- Pneumonia: Lower lobe pneumonia can cause referred abdominal pain. Symptoms include fever, cough, and difficulty breathing.
- Ectopic Pregnancy: Though rare in pediatric populations, it's a critical diagnosis to consider in post-menarchal girls with abdominal pain and a missed period.
Rare Diagnoses
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, gastrointestinal bleeding, or obstruction.
- Hirschsprung's Disease: A congenital condition affecting the large intestine, leading to severe constipation or intestinal obstruction.
- Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain, vomiting, and elevated pancreatic enzymes.
- Ovarian Torsion: A condition where the ovary twists around its ligaments, cutting off blood supply. It presents with severe abdominal pain and is an emergency.