Differential Diagnosis for 73-year-old Female with Abdominal Pain
Single Most Likely Diagnosis
- Diverticulitis: Although the CT scan reports diverticulosis without acute findings, the presence of diverticulosis and abdominal pain in an elderly patient makes diverticulitis a possible diagnosis, considering that early or mild cases might not show significant findings on CT.
Other Likely Diagnoses
- Musculoskeletal pain: The grade 1 spondylolisthesis at L4-5 could be causing referred pain to the abdomen, especially if the patient has a history of back pain or recent exacerbation.
- Gastrointestinal issues: Other gastrointestinal problems like constipation, gastroesophageal reflux disease (GERD), or irritable bowel syndrome (IBS) could cause abdominal pain and might not be visible on a CT scan.
- Urinary tract issues: Conditions such as urinary tract infections (UTIs) or kidney stones could cause abdominal pain and would require a urinalysis or other specific tests for diagnosis.
Do Not Miss Diagnoses
- Ovarian torsion or ovarian cyst: Although less common, ovarian torsion or a ruptured ovarian cyst can present with acute abdominal pain and might not be immediately visible on a CT scan, especially if the patient is post-menopausal.
- Appendicitis: Especially if the appendix is not well visualized on the CT scan, appendicitis remains a possibility, particularly in the elderly, where the presentation can be atypical.
- Mesenteric ischemia: This is a serious condition that can present with non-specific abdominal pain and might not have clear findings on a CT scan, especially in early stages.
- Ectopic pregnancy: Although highly unlikely in a 73-year-old female, it's theoretically possible if the patient has undergone fertility treatments or has an unusual medical history.
Rare Diagnoses
- Intra-abdominal malignancy: Certain cancers, like lymphoma or metastatic disease, could cause abdominal pain and might not be immediately apparent on a CT scan without specific findings like masses or lymphadenopathy.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain and might not have been previously diagnosed, especially if the patient has not undergone specific testing for these conditions.