Differential Diagnosis for Severe Lower Abdominal Pain in a 41-Year-Old Male
Single Most Likely Diagnosis
- Appendicitis: This is a common cause of severe lower abdominal pain, especially if the pain started near the belly button and then moved to the lower right abdomen. Appendicitis is an emergency that requires prompt surgical attention.
Other Likely Diagnoses
- Diverticulitis: Inflammation of the diverticula in the colon can cause severe lower abdominal pain, usually on the left side. It's more common in older adults but can occur in younger individuals.
- Kidney Stones: Pain from kidney stones can be severe and is often described as crampy. It typically starts in the flank and can radiate to the groin.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic or acute abdominal pain, often accompanied by changes in bowel habits or blood in the stool.
Do Not Miss Diagnoses
- Ectopic Pregnancy (in a female partner if applicable): Although the patient is male, it's essential to consider this in any differential for abdominal pain, especially if there's a female partner who could be pregnant. Ectopic pregnancy is life-threatening and requires immediate medical attention.
- Aortic Aneurysm: A ruptured abdominal aortic aneurysm can cause severe, sudden-onset abdominal pain and is immediately life-threatening.
- Ovarian Torsion (in a female partner if applicable): Similar to ectopic pregnancy, ovarian torsion is a gynecologic emergency that can cause severe abdominal pain and requires prompt intervention.
- Testicular Torsion: This condition involves the twisting of the spermatic cord and can cause severe pain in the testicle, which may radiate to the abdomen.
Rare Diagnoses
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially causing bowel obstruction. It's rare in adults but can cause severe abdominal pain.
- Mesenteric Ischemia: Reduced blood flow to the intestines can cause severe abdominal pain, often out of proportion to the physical examination findings.
- Pneumatosis Intestinalis: A condition characterized by gas in the intestinal wall, which can cause abdominal pain and is associated with various underlying conditions.