Differential Diagnosis for 10-year-old Female with Abdominal Pain
Single Most Likely Diagnosis
- Constipation: This is a common cause of abdominal pain in children, especially if they have not had a bowel movement recently or are experiencing hard stools. The absence of fever and presence of nausea support this diagnosis, as constipation can cause nausea.
Other Likely Diagnoses
- Viral Gastroenteritis: Although the patient does not have a fever, viral gastroenteritis can sometimes present without fever, especially in children. Nausea is a common symptom, and abdominal pain can be significant.
- Functional Abdominal Pain: This is a common cause of recurrent abdominal pain in children, often related to stress, anxiety, or dietary factors. The absence of other alarming symptoms (like fever, vomiting, or blood in stool) makes this a plausible diagnosis.
- Urinary Tract Infection (UTI): While UTIs often present with dysuria or frequency, some children may only complain of abdominal pain. The absence of fever does not rule out a UTI, especially in young girls.
Do Not Miss Diagnoses
- Appendicitis: Although less likely without fever, appendicitis can present atypically in children, and missing this diagnosis can have severe consequences. Early appendicitis might not have all the classic symptoms (fever, vomiting, localized right lower quadrant pain).
- Intussusception: This is a condition where a part of the intestine telescopes into another part, which can cause severe abdominal pain, nausea, and sometimes vomiting. It's more common in younger children but can occur in older children as well.
- Ovarian Torsion: This is a rare but emergency condition that can cause severe abdominal pain. It might not always present with fever, and nausea can be a symptom.
Rare Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with chronic abdominal pain, nausea, and changes in bowel habits. While less common in children, they should be considered if symptoms persist or worsen over time.
- Pancreatitis: This can cause severe abdominal pain and nausea. In children, it's often related to trauma, medications, or genetic conditions.
- Hepatitis: Although rare, hepatitis can cause abdominal pain, nausea, and might not always present with jaundice, especially in the early stages.