Differential Diagnosis for the Patient's Symptoms
The patient's symptoms of recurrent abdominal pain, particularly after eating, and normal laboratory results, suggest a functional gastrointestinal disorder. Here's a categorized differential diagnosis:
- Single most likely diagnosis
- Functional Biliary Type Pain (formerly known as Biliary Colic or Sphincter of Oddi Dysfunction Type III): The patient's symptoms of recurrent abdominal pain, especially after eating, and the absence of gallstones or other structural abnormalities, make this diagnosis the most likely. The normal laboratory results and imaging studies also support this diagnosis.
- Other Likely diagnoses
- Functional Dyspepsia: The patient's symptoms of abdominal pain, particularly after eating, and the presence of moderate erosive gastritis, suggest functional dyspepsia as a possible diagnosis.
- Sphincter of Oddi Dysfunction (SOD) Type II: Although less likely than functional biliary type pain, SOD Type II is still a possible diagnosis, given the patient's symptoms and the mild bile duct dilation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Pancreatic Cancer: Although the patient's serum lipase is normal, and the CT and MRCP are unremarkable, pancreatic cancer is a diagnosis that should not be missed. The patient's age and symptoms do not strongly suggest this diagnosis, but it should be considered.
- Cholangiocarcinoma: Similar to pancreatic cancer, cholangiocarcinoma is a rare but deadly diagnosis that should not be missed. The patient's symptoms and imaging results do not strongly suggest this diagnosis, but it should be considered.
- Rare diagnoses
- Primary Sclerosing Cholangitis: This rare autoimmune disorder can cause bile duct dilation and abdominal pain. Although the patient's laboratory results and imaging studies do not strongly suggest this diagnosis, it should be considered in the differential diagnosis.
- Primary Biliary Cholangitis: This rare autoimmune disorder can cause bile duct damage and abdominal pain. Although the patient's laboratory results and imaging studies do not strongly suggest this diagnosis, it should be considered in the differential diagnosis.