Abdominal Pain Differential Diagnosis
The differential diagnosis for abdominal pain is extensive and can be categorized into several groups. Here's a breakdown of the possible causes:
- Single Most Likely Diagnosis
- Gastroenteritis: This is often the most common cause of abdominal pain, especially if the pain is accompanied by symptoms like diarrhea, vomiting, and fever. The justification for this diagnosis is the high prevalence of gastrointestinal infections in the general population.
- Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): Characterized by chronic abdominal pain, bloating, and alteration of bowel habits, IBS is a common condition that can cause significant discomfort.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal pain, diarrhea, weight loss, and fatigue.
- Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause epigastric pain, especially after eating.
- Constipation: Severe constipation can lead to abdominal pain, bloating, and discomfort.
- Do Not Miss Diagnoses
- Appendicitis: Although not the most common cause, appendicitis is a medical emergency that requires prompt surgical intervention. It typically presents with right lower quadrant pain, fever, and vomiting.
- Ectopic Pregnancy: A life-threatening condition in women of childbearing age, ectopic pregnancy can cause severe abdominal pain, vaginal bleeding, and shock.
- Ruptured Aortic Aneurysm: A catastrophic event that can cause severe abdominal and back pain, rupture of an aortic aneurysm requires immediate medical attention.
- Mesenteric Ischemia: Reduced blood flow to the intestines can cause severe abdominal pain, nausea, and vomiting, and is a medical emergency.
- Rare Diagnoses
- Intussusception: A condition where a part of the intestine telescopes into another, intussusception can cause abdominal pain, vomiting, and bloody stools.
- Volvolus: A twisting of the intestine that can cut off blood flow, volvulus can cause severe abdominal pain, nausea, and vomiting.
- Pancreatic Cancer: Although rare, pancreatic cancer can cause abdominal pain, weight loss, and jaundice.
- Lead Poisoning: A rare cause of abdominal pain, lead poisoning can also cause constipation, fatigue, and developmental delays in children.
A thorough physical exam, including abdominal palpation, percussion, and auscultation, can help narrow down the differential diagnosis. Additionally, laboratory tests, imaging studies, and a detailed medical history are essential for making an accurate diagnosis.