Differential Diagnosis for 13-week-old Male with Inguinal/Testicular Hernia
- Single most likely diagnosis:
- Intussusception: This condition is a common cause of intestinal obstruction in infants, characterized by the telescoping of one portion of the intestine into another, leading to colicky pain, vomiting, and sometimes a palpable mass. The presence of crepitations on palpation and the absence of bowel movements for 8 days support this diagnosis.
- Other Likely diagnoses:
- Incarcerated inguinal hernia: Given the patient's age and symptoms, an incarcerated hernia is a possible cause, especially if the hernia is reducible and the patient has signs of obstruction.
- Testicular torsion: Although less likely given the presence of crepitations and the duration of symptoms, testicular torsion is a painful condition that requires urgent attention and can sometimes present with abdominal symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Volvulus: A twisting of the intestine that can lead to ischemia and necrosis, volvulus is a surgical emergency that requires prompt diagnosis and treatment.
- Strangulated hernia: If the blood supply to the herniated intestine is compromised, it can lead to gangrene and perforation, making it a critical condition to identify and treat urgently.
- Rare diagnoses:
- Meconium ileus: A condition associated with cystic fibrosis, meconium ileus is characterized by an obstruction of the small intestine due to inspissated meconium and can present with similar symptoms.
- Hirschsprung's disease: A congenital condition affecting the colon, leading to severe constipation or intestinal obstruction, which could be considered in the differential diagnosis of an infant with prolonged constipation and abdominal symptoms.