Differential Diagnosis for Abdominal Pain
The patient presents with left lower quadrant pain, bloating, constipation, dysuria, frequency, and hesitancy. Considering her symptoms and history, the following differential diagnoses are possible:
- Single Most Likely Diagnosis
- Constipation: The patient's recent onset of constipation since starting diabetes medication, along with symptoms of bloating, sharp pain, and difficulty having a bowel movement, makes constipation a likely diagnosis. The fact that she goes 2-3 days without a bowel movement and has difficulty draining also supports this diagnosis.
- Other Likely Diagnoses
- Urinary Tract Infection (UTI): The patient's symptoms of dysuria, frequency, and hesitancy suggest a possible UTI. Although she denies having fevers, UTIs can sometimes present without systemic symptoms.
- Irritable Bowel Syndrome (IBS): The patient's abdominal pain, bloating, and changes in bowel habits could be indicative of IBS, especially given the absence of any acute disease on the CT scan.
- Diverticulitis: Although the CT scan on 02/19/2025 showed no acute disease, diverticulitis can be a recurring condition, and the patient's left lower quadrant pain could be consistent with this diagnosis.
- Do Not Miss Diagnoses
- Appendicitis: Although the CT scan was negative, appendicitis can sometimes be missed on initial imaging. The patient's sharp pain and location in the left lower quadrant warrant consideration of this diagnosis.
- Ovarian Torsion: This is a rare but potentially life-threatening condition that requires prompt attention. The patient's sharp pain and history of similar pain in the past make it essential to consider this diagnosis.
- Intestinal Obstruction: The patient's constipation and difficulty having a bowel movement could be indicative of an intestinal obstruction, which would require immediate medical attention.
- Rare Diagnoses
- Inflammatory Bowel Disease (IBD): The patient's symptoms of abdominal pain, bloating, and changes in bowel habits could be indicative of IBD, although this would be less likely given the absence of any systemic symptoms or prior diagnosis.
- Endometriosis: The patient's left lower quadrant pain and history of similar pain in the past could be consistent with endometriosis, although this would be less likely given the absence of any menstrual-related symptoms.