Differential Diagnosis for 30y Female with Abdominal Pain
Single Most Likely Diagnosis
- Crohn's Disease: The patient's symptoms of abdominal pain, diarrhea, and worsening of pain with protein intake are consistent with Crohn's disease, a type of inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract. The CT findings of diffuse small bowel ileus and partial obstruction also support this diagnosis.
Other Likely Diagnoses
- Small Bowel Obstruction: The CT findings of partial obstruction and diffuse small bowel ileus suggest a possible mechanical obstruction, which could be due to adhesions, hernias, or other causes.
- Intestinal Lymphoma: The patient's symptoms and CT findings could also be consistent with intestinal lymphoma, a type of cancer that can cause abdominal pain, diarrhea, and bowel obstruction.
- Celiac Disease: Although the patient's symptoms do not worsen with gluten intake (rice and potatoes do not exacerbate pain), celiac disease is still a possible diagnosis, especially if the patient has a history of malabsorption or other symptoms consistent with the disease.
Do Not Miss Diagnoses
- Intussusception: A rare cause of bowel obstruction that can be life-threatening if not diagnosed promptly. The patient's symptoms and CT findings could be consistent with intussusception, especially if there is a lead point for the intussusception.
- Mesenteric Ischemia: A potentially life-threatening condition that can cause abdominal pain, diarrhea, and bowel obstruction. The patient's symptoms and CT findings could be consistent with mesenteric ischemia, especially if there is a history of cardiovascular disease or other risk factors.
- Appendicitis: Although the patient's symptoms are not typical for appendicitis, it is still a possible diagnosis that should not be missed, especially if the patient has a history of appendicitis or other symptoms consistent with the disease.
Rare Diagnoses
- Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which can cause abdominal pain, diarrhea, and bowel obstruction.
- Whipple's Disease: A rare bacterial infection that can cause malabsorption, diarrhea, and abdominal pain, which could be consistent with the patient's symptoms and CT findings.
- Gastrointestinal Amyloidosis: A rare condition characterized by deposition of amyloid protein in the gastrointestinal tract, which can cause abdominal pain, diarrhea, and bowel obstruction.