Differential Diagnosis for Mid Right Abdominal Pain on Deep Palpation
The following differential diagnosis is organized into categories to help guide the thought process:
- Single Most Likely Diagnosis
- Appendicitis: This is the most likely diagnosis due to the location of the pain (mid right abdomen) and the exacerbation of pain on deep palpation, which is a classic sign of appendicitis.
- Other Likely Diagnoses
- Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant pain that may radiate to the mid right abdomen and worsen with deep palpation.
- Peptic Ulcer Disease: A peptic ulcer in the duodenum can cause mid right abdominal pain, especially if it is located near the pylorus.
- Intestinal Obstruction: A partial or complete obstruction of the small intestine can cause abdominal pain, including in the mid right region, and may worsen with deep palpation.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, including in the mid right region, and may worsen with deep palpation.
- Do Not Miss Diagnoses
- Ectopic Pregnancy: Although less likely, an ectopic pregnancy can cause abdominal pain, including in the mid right region, and is a life-threatening condition if missed.
- Ruptured Aortic Aneurysm: A ruptured abdominal aortic aneurysm can cause severe abdominal pain, including in the mid right region, and is a medical emergency.
- Ovarian Torsion: Torsion of the ovary can cause severe abdominal pain, including in the mid right region, and is a surgical emergency.
- Rare Diagnoses
- Mesenteric Lymphadenitis: Inflammation of the lymph nodes in the mesentery can cause abdominal pain, including in the mid right region.
- Right Lower Lobe Pneumonia: A pneumonia in the right lower lobe can cause referred pain to the mid right abdomen.
- Pancreatitis: Although pancreatitis typically causes upper abdominal pain, it can occasionally cause mid right abdominal pain, especially if the pancreatic tail is involved.