Differential Diagnosis for Diaphoresis and Vomiting Dark Brown Contents

Single Most Likely Diagnosis

• Gastrointestinal Bleed: The patient's symptom of vomiting dark brown contents, which is often indicative of digested blood, points towards a gastrointestinal bleed as the most likely diagnosis. Diaphoresis can accompany the pain and stress associated with such an event.

Other Likely Diagnoses

• Food Poisoning or Gastroenteritis: These conditions can cause severe vomiting, which may appear dark brown if the patient has consumed coffee, chocolate, or certain medications. Diaphoresis can occur due to the systemic response to infection or toxin.
• Acute Pancreatitis: This condition can cause severe abdominal pain, vomiting, and diaphoresis. While the vomit may not always be dark brown, the combination of symptoms warrants consideration.
• Severe Dehydration: Leading to electrolyte imbalances, which can cause muscle cramps, vomiting, and diaphoresis. The vomit's appearance might be altered due to the concentration of bile or other substances.

Do Not Miss Diagnoses

• Myocardial Infarction (MI): Although less common, an MI can present atypically with vomiting and diaphoresis, especially in diabetic or elderly patients. The dark brown vomit might not be directly related but could be a sign of stress-induced gastrointestinal response.
• Pulmonary Embolism (PE): Similar to MI, a PE can cause sudden onset of symptoms including vomiting and diaphoresis. The connection to dark brown vomit is less direct but could be part of a systemic stress response.
• Septic Shock: This is a life-threatening condition that can cause a wide range of symptoms including vomiting and diaphoresis. The appearance of the vomit might be altered due to various factors including medications or the underlying cause of sepsis.

Rare Diagnoses

• Hematemesis due to a Rare Cause (e.g., AV Malformation, Tumor): While rare, these conditions can cause gastrointestinal bleeding leading to dark brown vomit. Diaphoresis could accompany the pain or systemic response.
• Mallory-Weiss Tear: This is a rare cause of upper gastrointestinal bleeding, often associated with intense or prolonged vomiting, which could potentially lead to dark brown vomit if the blood is partially digested.
• Boerhaave Syndrome: A rare but serious condition involving a rupture of the esophagus, which can lead to severe vomiting and potentially altered appearance of the vomit, along with diaphoresis due to pain and stress.