Differential Diagnosis for Right Upper Quadrant Stomach Pain and Tingling in Extremities after Heavy Alcohol Consumption

• Single Most Likely Diagnosis
  • Acute Pancreatitis: This condition is often associated with heavy alcohol consumption and can cause upper abdominal pain, typically radiating to the back, and may also lead to systemic symptoms such as sweating. The tingling in extremities could be related to electrolyte imbalances or nutritional deficiencies secondary to pancreatitis.
• Other Likely Diagnoses
  • Alcoholic Hepatitis: Heavy alcohol use can lead to liver inflammation, causing right upper quadrant pain, and systemic symptoms like sweating. While less directly linked to tingling in extremities, liver dysfunction can lead to a variety of neurological symptoms.
  • Gastritis or Peptic Ulcer Disease: Alcohol can irritate the stomach lining, leading to gastritis or exacerbate peptic ulcer disease, causing upper abdominal pain. The tingling could be a less common manifestation of severe gastritis or related to alcohol withdrawal.
• Do Not Miss Diagnoses
  • Myocardial Infarction: Although less common, chest pain or discomfort can sometimes be referred to the upper abdomen. The sweating episodes could be indicative of cardiac ischemia, making this a critical diagnosis not to miss, especially in individuals with risk factors.
  • Diabetic Ketoacidosis (DKA) or Hyperosmolar Hyperglycemic State (HHS): Both conditions can present with abdominal pain and systemic symptoms like sweating. The tingling in extremities could be due to electrolyte imbalances or neuropathy associated with diabetes.
  • Porphyria: This group of disorders can cause severe abdominal pain, neurological symptoms (including tingling in extremities), and psychiatric symptoms. While rare, it's a diagnosis that could explain the combination of symptoms and would be critical to identify due to its potential severity.
• Rare Diagnoses
  • Lead Poisoning: Could cause abdominal pain and neurological symptoms such as tingling, but would be less likely without a clear exposure history.
  • Thiamine Deficiency (Wernicke's Encephalopathy): Associated with chronic alcohol abuse, it can cause neurological symptoms, but the abdominal pain would be less characteristic.
  • Hypothyroidism or Hyperthyroidism: Both conditions can cause a variety of systemic symptoms including abdominal pain and neurological manifestations, but would be less directly linked to the acute presentation after heavy alcohol consumption.