Differential Diagnosis for 43 yo Male with Right Lower Abdominal Pain
Single Most Likely Diagnosis
- Appendicitis: The patient's presentation of increasing right lower abdominal pain over 2 days is classic for appendicitis, which is one of the most common causes of acute abdominal pain requiring surgical intervention.
Other Likely Diagnoses
- Diverticulitis: Although more common on the left side, diverticulitis can occur on the right and cause similar symptoms. The patient's age and symptoms could align with this diagnosis.
- Kidney Stone: A stone in the right ureter could cause severe pain that might be perceived in the right lower abdomen. The pain typically starts in the flank and radiates down.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic or acute abdominal pain, including in the right lower quadrant, especially if there is involvement of the terminal ileum.
Do Not Miss Diagnoses
- Ectopic Pregnancy: Although extremely rare in males, it's essential to consider in any patient with abdominal pain. However, given the patient is male, this is not applicable.
- Ruptured Abdominal Aortic Aneurysm: This is a life-threatening condition that can present with abdominal pain, but it's more common in older individuals and typically associated with back pain and hypotension.
- Ovarian Torsion: Again, not applicable in males, but important to consider in females.
- Intestinal Obstruction: This can cause severe abdominal pain, vomiting, and constipation. It's crucial to identify early due to the risk of bowel ischemia.
- Mesenteric Ischemia: A condition where the blood flow to the intestines is compromised, leading to severe abdominal pain out of proportion to the physical examination findings.
Rare Diagnoses
- Right Lower Lobe Pneumonia: In some cases, pneumonia can cause referred pain to the abdomen, especially if the diaphragm is involved.
- Yersinia Ileitis: A rare cause of right lower quadrant abdominal pain due to infection with Yersinia enterocolitica.
- Meckel's Diverticulitis: A congenital anomaly of the small intestine that can cause inflammation and mimic appendicitis.
- Intussusception: A condition where a part of the intestine telescopes into another part, which can cause abdominal pain, but is more common in children.