Differential diagnosis of puffy

eyes

Periorbital puffiness• They are known as “puffy eyes” or swelling around the

eyes.• It is exclusively caused by a fluid build up around the

eyes.• Some degree of puffiess may be normal for some

specific individual, factors such as age and fatigue.

Causes of Periorbital PuffinessMost common:• Fluid retention• Crying• Nephrotic syndrome• Normal aging

Less common:• Chargas disease• Periorbital cellulitis

Nephrotic syndrome

This is the most appropriate diagnosis of the 5 years old child.

Puffy eyes are most probably caused by the fluid retention due to the decrease oncotic pressure in the blood. This forces fluid to flow into the tissue space. Accumulation of the fluid causes edema.

Puffy eyes alone cannot be use to indicate the presence of nephrotic syndrome or other disease, more symptoms must be included in the diagnosis.

Differential diagnosis of Abdominal distention

A swollen abdomen occurs when your stomach area is larger than normal. This is sometimes called a distended abdomen or swollen belly. A swollen abdomen has a number of potential causes, and it is a common occurrence.

Symptoms of abdominal distentionMost common:• Irritable Bowel Syndrome• Lactose intolerance• Indigestion(dyspepsia) • Ascites

Less common:• Gallstone• Pregnancy• Malabsorption syndrome• Hirschsprung disease• Peritonitis• Intestinal Obstruction• Celiac Disease (Gluten Intolerance)• Heart failure• Biliary (Bile Duct) Obstruction• Kwashiorkor• Stomach Cancer (Gastric Adenocarcinoma)