Differential Diagnosis for Colicky Abdominal Pain
Single Most Likely Diagnosis
- Kidney Stones (Nephrolithiasis): This condition is characterized by severe, episodic pain, often radiating from the flank to the groin, which is a classic presentation of colicky abdominal pain. The pain is usually accompanied by nausea, vomiting, and sometimes blood in the urine.
Other Likely Diagnoses
- Intestinal Obstruction: This condition can cause colicky pain due to the intermittent obstruction of the intestine, leading to abdominal distension, vomiting, and constipation.
- Gallbladder Disease (Cholecystitis or Cholelithiasis): Gallstones can cause colicky pain in the right upper quadrant of the abdomen, especially after eating fatty foods.
- Diverticulitis: Inflammation of the diverticula in the colon can cause colicky pain, usually in the left lower quadrant, accompanied by changes in bowel habits and fever.
Do Not Miss Diagnoses
- Appendicitis: Although the pain of appendicitis is often described as steady and worsening over time, it can start as colicky pain. Missing this diagnosis can lead to perforation and peritonitis.
- Ectopic Pregnancy: This is a life-threatening condition that can present with colicky pain, especially in women of childbearing age. A missed diagnosis can lead to rupture and severe bleeding.
- Aortic Dissection: A tear in the aorta can cause severe, colicky pain that radiates to the back, which is a medical emergency requiring immediate attention.
- Ovarian Torsion: This condition can cause severe, colicky pain in the lower abdomen, usually on one side, and is a surgical emergency.
Rare Diagnoses
- Lead Poisoning: Chronic lead exposure can cause colicky abdominal pain, along with other symptoms like constipation and neurological deficits.
- Porphyria: A group of rare genetic disorders that can cause colicky abdominal pain, along with neurological and psychiatric symptoms.
- Mesenteric Ischemia: A rare condition where the blood flow to the intestine is compromised, causing colicky pain, usually accompanied by bloody stools and abdominal tenderness.