Differential Diagnosis for a 28 YOM with Severe Vomiting
Single Most Likely Diagnosis
- Gastroenteritis: This is a common cause of severe vomiting, and the presence of bile in the vomit suggests an obstruction or ileus. The constipation and lack of bowel movement for 2 days further support this diagnosis. The recent history of cardiac ablation is less likely to be directly related to the current symptoms.
Other Likely Diagnoses
- Intestinal Obstruction: The symptoms of severe vomiting, constipation, and lack of bowel movement are consistent with an intestinal obstruction. This could be due to various causes such as adhesions, hernias, or volvulus.
- Mesenteric Ischemia: Although less common, mesenteric ischemia can cause severe vomiting, abdominal pain, and constipation. The patient's history of cardiac ablation and WPW may increase the risk of thromboembolic events.
- Food Poisoning: Food poisoning can cause severe vomiting, and the presence of bile in the vomit does not rule out this diagnosis.
Do Not Miss Diagnoses
- Appendicitis: Although the symptoms are not typical, appendicitis can present with vomiting and constipation. Missing this diagnosis could lead to severe consequences, including perforation and peritonitis.
- Myocardial Infarction: Although the patient has a history of cardiac ablation, myocardial infarction can still occur. Vomiting can be a symptom of MI, especially in younger patients.
- Pulmonary Embolism: The patient's history of cardiac ablation and WPW may increase the risk of thromboembolic events, including pulmonary embolism. Severe vomiting can be a symptom of PE.
Rare Diagnoses
- Porphyria: This is a rare genetic disorder that can cause severe vomiting, abdominal pain, and constipation.
- Cyclic Vomiting Syndrome: This is a rare condition characterized by recurrent episodes of severe vomiting, often with no apparent cause.
- Neurological Disorders: Certain neurological disorders, such as brain tumors or meningitis, can cause severe vomiting. However, these are less likely given the patient's presentation and history.