Differential Diagnosis for Abdominal Pain, Mid Epigastric Pain, Nausea, and Vomiting
The patient's symptoms of abdominal pain, mid epigastric pain, nausea, and vomiting can be caused by various conditions. Here's a categorized differential diagnosis:
- Single Most Likely Diagnosis
- Peptic Ulcer Disease (PUD): This is a common cause of mid epigastric pain, nausea, and vomiting. The pain is often described as burning or gnawing and can be related to food intake.
- Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): Symptoms can include mid epigastric pain, nausea, and vomiting, especially after eating or at night.
- Gastritis: Inflammation of the stomach lining can cause abdominal pain, nausea, and vomiting.
- Pancreatitis: Inflammation of the pancreas can cause severe mid epigastric pain, nausea, and vomiting.
- Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant pain, but can also refer pain to the mid epigastric region.
- Do Not Miss Diagnoses
- Myocardial Infarction (MI): Although the pain is typically more retrosternal, some MIs can present with epigastric pain, especially in women or diabetic patients.
- Aortic Dissection: Severe, tearing chest or abdominal pain can be a sign of this life-threatening condition.
- Mesenteric Ischemia: Sudden onset of severe abdominal pain, nausea, and vomiting can be a sign of this condition, which requires prompt intervention.
- Ectopic Pregnancy: Although more common in women with missed periods, an ectopic pregnancy can cause abdominal pain, nausea, and vomiting.
- Rare Diagnoses
- Zollinger-Ellison Syndrome: A rare condition characterized by excessive gastric acid production, leading to severe peptic ulcers and abdominal pain.
- Porphyria: A group of rare genetic disorders that can cause abdominal pain, nausea, and vomiting, often accompanied by neurological symptoms.
- Intestinal Obstruction: A rare cause of abdominal pain, nausea, and vomiting, often accompanied by abdominal distension and constipation.
Each of these diagnoses has distinct characteristics, but it's essential to consider the entire differential diagnosis to ensure that potentially life-threatening conditions are not missed.