Differential Diagnosis for 30y Female with Abdominal Pain
- Single most likely diagnosis
- Pancreatitis: The elevated amylase level (315) is a strong indicator of pancreatitis, which is often associated with abdominal pain, especially after eating. The fact that she can tolerate potatoes and rice, which are low in fat, suggests that the pain may be related to fat stimulation of the pancreas.
- Other Likely diagnoses
- Peptic Ulcer Disease (PUD): Although the amylase level is elevated, PUD can still be a consideration, especially if the patient has a history of NSAID use or Helicobacter pylori infection. The pain associated with eating could be related to acid production.
- Gastroparesis: This condition, characterized by delayed gastric emptying, can cause abdominal pain, nausea, and vomiting after eating. The fact that she can tolerate certain foods may suggest a motility disorder.
- Do Not Miss diagnoses
- Intestinal Ischemia: This is a life-threatening condition that requires prompt diagnosis and treatment. Although the patient's symptoms and lab results do not strongly suggest ischemia, it is essential to consider this diagnosis to avoid missing a potentially fatal condition.
- Mesenteric Lymphadenitis: This condition, often associated with viral or bacterial infections, can cause abdominal pain and may be accompanied by elevated inflammatory markers.
- Rare diagnoses
- Eosinophilic Gastroenteritis: This rare condition is characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, nausea, and vomiting. The patient's symptoms and lab results do not strongly suggest this diagnosis, but it should be considered if other diagnoses are ruled out.
- Celiac Disease: Although the patient can tolerate rice, celiac disease is an autoimmune disorder that can cause abdominal pain, diarrhea, and malabsorption. The fact that she can eat potatoes and rice without symptoms does not entirely rule out this diagnosis, but it makes it less likely.