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Differential Diagnosis for Acute Onset of Abdominal Pain in an 80-Year-Old Male

Single Most Likely Diagnosis

  • Diverticulitis: This condition is common in the elderly population and typically presents with acute onset of left lower quadrant abdominal pain, fever, and changes in bowel habits. The patient's age and the location of the pain make diverticulitis a highly plausible diagnosis.

Other Likely Diagnoses

  • Sigmoid Volvulus: Although less common than diverticulitis, sigmoid volvulus can cause severe abdominal pain and is more prevalent in older adults. It typically presents with abdominal distension and obstipation.
  • Constipation: Elderly individuals are prone to constipation, which can cause significant abdominal pain, especially if there is fecal impaction. The pain is often diffuse but can be localized to the left lower quadrant.
  • Left-Sided Inflammatory Bowel Disease (IBD): Conditions like ulcerative colitis or Crohn's disease can present with abdominal pain, diarrhea, and weight loss. While less common in new onset at this age, it's a consideration, especially if there's a history of similar symptoms.

Do Not Miss Diagnoses

  • Ectopic Abdominal Aortic Aneurysm (AAA) Rupture: Although AAA typically presents with back or mid-abdominal pain, a ruptured aneurysm can cause pain to radiate to the left lower quadrant. This is a medical emergency with high mortality if not promptly treated.
  • Mesenteric Ischemia: This condition, often due to embolism or thrombosis of the mesenteric arteries, can cause severe, acute abdominal pain out of proportion to physical findings. It's critical to diagnose early to prevent bowel infarction.
  • Ovarian Torsion (in the case of a female patient, but mentioned for completeness): Not applicable in this male patient scenario, but an important consideration in female patients with acute abdominal pain.

Rare Diagnoses

  • Intussusception: A condition where a part of the intestine telescopes into another, intussusception is rare in adults and can cause abdominal pain, vomiting, and bloody stools. It's more common in children but can occur in adults, often associated with a lead point like a tumor.
  • Inferior Mesenteric Artery Embolism: Similar to mesenteric ischemia but involving the inferior mesenteric artery, this is a rare cause of acute abdominal pain, usually presenting with ischemia of the sigmoid colon and rectum.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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