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For a 14-year-old girl presenting with nausea and abdominal pain for 3 weeks, and a history of neck trauma 3 months ago on a trampoline, you'd want to consider both common and less common but serious causes. The neck trauma might be relevant, especially if neurologic or autonomic symptoms are playing a role.
🧠 Differential Diagnosis (DDx)
1. Gastrointestinal causes (most likely)
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Functional abdominal pain / IBS
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Gastritis or peptic ulcer disease – especially if NSAIDs used post-injury.
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Constipation – common in teens, may cause chronic pain and nausea.
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GERD – reflux-related nausea, epigastric pain.
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H. pylori infection
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Food intolerances (e.g. lactose, celiac disease)
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Appendicitis (chronic) – less common but worth keeping in mind.
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Ovarian pathology (e.g. cysts, torsion, endometriosis)
2. Neurologic / Autonomic causes (possibly related to neck trauma)
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Post-concussion syndrome – even with no obvious head injury, cervical trauma can cause vestibular dysfunction, nausea, and headaches.
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Cervicogenic vertigo – neck injury causing dizziness, nausea, imbalance.
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Autonomic dysfunction / POTS (Postural Orthostatic Tachycardia Syndrome) – often triggered by trauma or viral illness, causing nausea, lightheadedness, palpitations, abdominal pain.
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Chiari malformation (less common) – can cause nausea, headache, and is occasionally unmasked after trauma.
3. Other systemic or psychological causes
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Pregnancy – always rule out in teens with nausea.
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Depression/anxiety or somatization – can present with chronic nausea and pain.
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Infections – subacute viral illness or mononucleosis.
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Metabolic/endocrine – e.g. DKA, thyroid issues (less likely without other signs).
⚠️ Red flags to assess:
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Weight loss
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Night pain or waking from sleep
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Neurologic symptoms (headaches, dizziness, vision changes)
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Change in bowel/bladder habits
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Fever, systemic signs
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Focal abdominal tenderness
Would you like a suggested workup or approach to this case?
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