Differential Diagnosis for Acute Diverticulitis
Single Most Likely Diagnosis
- Acute diverticulitis: This is the most likely diagnosis given the presentation, as diverticulitis is a common condition characterized by inflammation of a diverticulum in the wall of the colon, often presenting with acute abdominal pain, tenderness, and changes in bowel habits.
Other Likely Diagnoses
- Irritable bowel syndrome (IBS): Although IBS is a chronic condition, its symptoms can sometimes mimic those of acute diverticulitis, including abdominal pain and changes in bowel habits.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can present with similar symptoms to diverticulitis, including abdominal pain, diarrhea, and weight loss.
- Gastroenteritis: Infection of the stomach and intestines can cause acute abdominal pain, diarrhea, and vomiting, which might be confused with diverticulitis.
- Appendicitis: Although the pain location differs, appendicitis can sometimes present with similar systemic symptoms like fever and abdominal tenderness.
Do Not Miss Diagnoses
- Perforated viscus: A hole in the wall of the intestine can lead to peritonitis, which is life-threatening and requires immediate surgical intervention. The symptoms can overlap with diverticulitis, especially if there's associated peritonitis.
- Ectopic pregnancy: In women of childbearing age, an ectopic pregnancy can present with acute abdominal pain and might be mistaken for diverticulitis. It's a medical emergency that requires prompt diagnosis and treatment.
- Mesenteric ischemia: Reduced blood flow to the intestines can cause severe abdominal pain and might be confused with diverticulitis. It's a serious condition that can lead to bowel infarction if not treated promptly.
- Ovarian torsion: In women, ovarian torsion can cause severe, acute abdominal pain and might be mistaken for diverticulitis. It's an emergency that requires immediate surgical intervention.
Rare Diagnoses
- Epiploic appendagitis: Inflammation of the epiploic appendages (small, fatty structures attached to the colon) can cause acute abdominal pain and might be confused with diverticulitis.
- Colonic volvulus: Twisting of a portion of the colon can cause acute abdominal pain, obstruction, and might be mistaken for diverticulitis.
- Intussusception: Telescoping of one segment of intestine into another can cause acute abdominal pain, obstruction, and might be confused with diverticulitis, especially in adults.
- Solitary rectal ulcer syndrome: Although more chronic, this condition can sometimes present acutely and might be mistaken for diverticulitis due to overlapping symptoms like rectal pain and bleeding.