Differential Diagnosis for Abdominal Pain, Vomiting, Diarrhea, Raised White Cells, and Dehydration
- Single Most Likely Diagnosis
- Gastroenteritis: This is the most likely diagnosis given the combination of abdominal pain, vomiting, diarrhea, and dehydration. The raised white cell count suggests an infectious or inflammatory cause, which is consistent with gastroenteritis.
- Other Likely Diagnoses
- Appendicitis: Although the presence of diarrhea is not typical, appendicitis can sometimes present with a range of gastrointestinal symptoms including abdominal pain, vomiting, and raised white cells.
- Intestinal obstruction: This condition can cause abdominal pain, vomiting, and dehydration. While diarrhea is less common, it can occur depending on the level and completeness of the obstruction.
- Food poisoning: Similar to gastroenteritis, food poisoning can cause a range of symptoms including abdominal pain, vomiting, diarrhea, and dehydration, often with an elevated white cell count.
- Do Not Miss Diagnoses
- Perforated viscus: Although less likely, a perforated viscus (such as a perforated ulcer or perforated appendix) is a medical emergency that requires immediate attention. Symptoms can include severe abdominal pain, vomiting, and signs of peritonitis, with raised white cells indicating infection.
- Mesenteric ischemia: This condition involves insufficient blood flow to the intestines and can present with abdominal pain, vomiting, and diarrhea. It is a serious condition that can lead to bowel infarction if not promptly treated.
- Intussusception: More common in children but can occur in adults, intussusception is a condition where a part of the intestine telescopes into another part, leading to obstruction and potentially ischemia. It's a surgical emergency.
- Rare Diagnoses
- Whipple's disease: A rare, systemic bacterial infection that can cause malabsorption, weight loss, abdominal pain, and diarrhea.
- Eosinophilic gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, vomiting, diarrhea, and sometimes dehydration.
- Tropical sprue: A rare condition seen in certain tropical regions, characterized by malabsorption, abdominal pain, diarrhea, and weight loss.