Differential Diagnosis of Abdominal Pain
Abdominal pain is a common symptom with a wide range of possible causes. The differential diagnosis can be organized into the following categories:
- Single Most Likely Diagnosis
- Gastroenteritis: This is often the most common cause of abdominal pain, especially if the pain is accompanied by nausea, vomiting, and diarrhea. The justification for this diagnosis is the high prevalence of viral and bacterial infections that affect the gastrointestinal tract.
- Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): A chronic condition characterized by recurring abdominal pain, bloating, and changes in bowel movements. IBS is a common cause of abdominal pain in the absence of other symptoms.
- Constipation: Can cause significant abdominal pain and discomfort, especially if the constipation is severe or chronic.
- Peptic Ulcer Disease: Includes gastric and duodenal ulcers, which can cause epigastric pain that may radiate to the back.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, and weight loss.
- Diverticulitis: Inflammation of the diverticula in the colon can cause left lower quadrant abdominal pain.
- Do Not Miss Diagnoses
- Appendicitis: Although not the most common cause, appendicitis is a surgical emergency that requires prompt diagnosis and treatment to prevent perforation and peritonitis.
- Ectopic Pregnancy: A life-threatening condition in women of childbearing age, presenting with abdominal pain and vaginal bleeding.
- Ruptured Aortic Aneurysm: A catastrophic event that can cause severe abdominal and back pain, often accompanied by hypotension.
- Mesenteric Ischemia: A condition where the blood flow to the intestines is compromised, leading to severe abdominal pain and potentially life-threatening complications.
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain radiating to the back, often accompanied by nausea and vomiting.
- Rare Diagnoses
- Intussusception: A condition where a part of the intestine telescopes into another part, causing abdominal pain and potentially leading to bowel obstruction.
- Volvolus: A twisting of the intestine that can cause severe abdominal pain and bowel obstruction.
- Abdominal Migraine: A condition characterized by recurrent episodes of abdominal pain, often accompanied by other migraine symptoms.
- Porphyria: A group of rare genetic disorders that can cause abdominal pain, among other symptoms.
- Lead Poisoning: Can cause abdominal pain, constipation, and other systemic symptoms.
Each of these diagnoses has a unique set of clinical features and risk factors that can help guide the diagnostic process. A thorough history, physical examination, and diagnostic tests are essential for determining the underlying cause of abdominal pain.