Differential Diagnosis for Sudden Abdominal Pain with Elevated WBC
Single Most Likely Diagnosis
- Acute Appendicitis: Although not listed in the options, acute appendicitis is a common cause of sudden abdominal pain and elevated white blood cell (WBC) count. The symptoms and lab results provided could align with this condition, especially if the pain is localized to the right lower quadrant.
Other Likely Diagnoses
- Acute Pancreatitis: This is a plausible diagnosis given the sudden onset of abdominal pain and significantly elevated WBC count. Acute pancreatitis can cause severe abdominal pain and can lead to an elevated WBC count due to the inflammatory response.
- Dudenal Perforation: A perforation in the duodenum can lead to peritonitis, which would explain the severe abdominal pain and elevated WBC count. This condition is a surgical emergency.
Do Not Miss Diagnoses
- Ischemic Bowel: Although less common, ischemic bowel disease can present with sudden abdominal pain and an elevated WBC count. It's crucial not to miss this diagnosis because timely intervention is necessary to prevent bowel necrosis and perforation.
- Ectopic Pregnancy: In a female patient of childbearing age, ectopic pregnancy must be considered, especially if there's a history of missed periods or positive pregnancy test. It's a life-threatening condition that requires immediate attention.
- Ruptured Ovarian Cyst: Another condition that could lead to sudden abdominal pain and elevated WBC count in a female patient. While not always life-threatening, it can lead to significant morbidity if not promptly addressed.
Rare Diagnoses
- Mesenteric Lymphadenitis: This condition involves inflammation of the lymph nodes in the mesentery and can mimic appendicitis or other causes of abdominal pain. It's less common but should be considered in the differential diagnosis, especially if other causes are ruled out.
- Intra-abdominal Tuberculosis: Although rare in many parts of the world, abdominal tuberculosis can cause chronic or acute abdominal pain, along with an elevated WBC count. It's an important consideration in patients from endemic areas or with a history of tuberculosis.