Differential Diagnosis for Hematuria and Stomach Pain
Single Most Likely Diagnosis
- Gastrointestinal Bleed: This is the most likely diagnosis as it directly correlates with both hematuria (if the blood is coming from the lower GI tract) and stomach pain. The presence of blood in the urine could be a sign of a severe bleed that has led to blood being visible in the urine, especially if the patient is experiencing significant blood loss.
Other Likely Diagnoses
- Kidney Stones: These can cause severe stomach or flank pain and hematuria. The pain is often colicky in nature, and the hematuria can range from microscopic to gross.
- Urinary Tract Infection (UTI): While more commonly associated with dysuria and frequency, a severe UTI, especially pyelonephritis, can cause flank pain and hematuria.
- Gastritis or Peptic Ulcer Disease: These conditions can cause stomach pain and, if bleeding is present, could potentially lead to hematuria if the bleed is significant enough to affect the urinary system indirectly.
Do Not Miss Diagnoses
- Abdominal Aortic Aneurysm (AAA): Although less common, an AAA can cause abdominal pain and, if ruptured, could lead to hematuria due to the proximity of the aorta to the kidneys and urinary tract. This is a medical emergency.
- Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can cause abdominal pain and, if ruptured, could lead to internal bleeding that might be mistaken for hematuria.
- Sepsis: Sepsis from any cause can lead to multi-organ dysfunction, including renal impairment that might result in hematuria, and abdominal pain if the source of infection is intra-abdominal.
Rare Diagnoses
- Goodpasture Syndrome: A rare autoimmune disease that can cause glomerulonephritis leading to hematuria and, in some cases, abdominal pain due to the systemic nature of the disease.
- Alport Syndrome: A genetic disorder affecting the type IV collagen in the body, leading to kidney disease, hearing loss, and eye abnormalities. It could present with hematuria, and abdominal pain might be a secondary symptom due to associated conditions.
- Sickle Cell Disease: While primarily known for causing anemia and pain crises, sickle cell disease can lead to renal complications, including hematuria, and abdominal pain due to sickling crises affecting various organs.