Differential Diagnosis for 75yo with Lower Abdominal Pain
Single Most Likely Diagnosis
- Diverticulitis: This is a common condition in the elderly, characterized by inflammation of the diverticula in the colon, which can cause moderate to severe pain in the lower abdomen, exacerbated by palpation and movement.
Other Likely Diagnoses
- Urinary Tract Infection (UTI): A common condition in the elderly, especially women, which can cause lower abdominal pain, dysuria, and frequency.
- Constipation: Can cause significant abdominal pain and discomfort, especially in the elderly, and may be exacerbated by movement or position changes.
- Inguinal Hernia: May cause lower abdominal pain, especially with coughing, straining, or movement, and is more common in older adults.
- Ovarian Cyst (in females) or Prostatitis (in males): Although less common, these conditions can cause lower abdominal pain and should be considered in the differential diagnosis.
Do Not Miss Diagnoses
- Appendicitis: Although less common in the elderly, appendicitis can present atypically and may not always have the classic symptoms of nausea, vomiting, and fever.
- Bowel Obstruction: Can cause severe abdominal pain, vomiting, and constipation, and is a medical emergency that requires prompt diagnosis and treatment.
- Ectopic Pregnancy (in females of childbearing age): A life-threatening condition that requires immediate attention, although unlikely in a 75-year-old patient.
- Aortic Aneurysm: A ruptured abdominal aortic aneurysm can cause severe abdominal pain and is a medical emergency that requires prompt diagnosis and treatment.
Rare Diagnoses
- Carcinoid Syndrome: A rare condition caused by a neuroendocrine tumor that can produce serotonin and cause abdominal pain, diarrhea, and flushing.
- Mesenteric Ischemia: A rare condition caused by decreased blood flow to the intestines, which can cause severe abdominal pain and is a medical emergency.
- Endometriosis (in females): A rare condition in postmenopausal women, which can cause chronic pelvic pain and should be considered in the differential diagnosis.
- Retroperitoneal Fibrosis: A rare condition characterized by inflammation and fibrosis in the retroperitoneal space, which can cause abdominal pain and urinary obstruction.