Differential Diagnosis for Abdominal Pain with Inguinal Lymphadenopathy in a 66-Year-Old
Single Most Likely Diagnosis
- Diverticulitis with lymphadenopathy: This condition is common in older adults and can cause abdominal pain, particularly in the lower left quadrant. Inguinal lymphadenopathy can occur due to the spread of infection or inflammation from the diverticula to the lymph nodes.
Other Likely Diagnoses
- Colorectal cancer with metastasis: Abdominal pain and inguinal lymphadenopathy can be symptoms of colorectal cancer that has metastasized to the lymph nodes. The age of the patient increases the likelihood of this diagnosis.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause abdominal pain and lymphadenopathy, including inguinal lymph nodes, due to chronic inflammation and potential complications.
- Gastrointestinal infection: Certain infections, such as those caused by Salmonella or Shigella, can lead to abdominal pain and lymphadenopathy, including in the inguinal region, especially if the infection spreads or complicates.
Do Not Miss Diagnoses
- Lymphoma: Although less common, lymphoma (including non-Hodgkin lymphoma) can present with lymphadenopathy, including in the inguinal region, and abdominal pain due to involvement of abdominal lymph nodes or organs.
- Abdominal aortic aneurysm: This is a medical emergency that can cause abdominal pain and, in some cases, may be associated with lymphadenopathy due to inflammation or rupture. The age of the patient increases the risk for this condition.
- Testicular cancer with metastasis: Although testicular cancer is more common in younger men, it can occur in older adults. Metastasis to the inguinal lymph nodes can cause lymphadenopathy, and abdominal pain can occur if the cancer spreads to abdominal organs.
Rare Diagnoses
- Whipple's disease: A rare, systemic bacterial infection that can cause abdominal pain, weight loss, and lymphadenopathy, including in the inguinal region, due to malabsorption and systemic inflammation.
- Castleman disease: A rare disorder that involves an overgrowth of cells in the lymph nodes, which can cause lymphadenopathy, including in the inguinal region, and may be associated with abdominal pain due to organ involvement or compression.
- Kaposi's sarcoma: A type of cancer that can cause lymphadenopathy and abdominal pain, particularly in immunocompromised patients, such as those with HIV/AIDS. It is rare in the general population but should be considered in high-risk individuals.