Differential Diagnosis for Acute Distended Abdomen
Single Most Likely Diagnosis
- Intestinal Obstruction: This is often the most common cause of an acute distended abdomen, especially in patients with a history of abdominal surgery, hernias, or tumors. The obstruction can be mechanical (due to a physical blockage) or non-mechanical (due to a functional issue), leading to the accumulation of gas and fluid, causing abdominal distension.
Other Likely Diagnoses
- Ileus: Postoperative ileus or adynamic ileus can cause abdominal distension due to the temporary cessation of the normal contractions of the bowel muscles. This can occur after surgery, after certain medications, or due to various medical conditions.
- Inflammatory Bowel Disease (IBD) Flare: Conditions like Crohn's disease or ulcerative colitis can cause significant abdominal distension during a flare, due to inflammation and potential obstruction.
- Gastroenteritis: Severe cases of gastroenteritis can lead to significant fluid loss and electrolyte imbalance, potentially causing ileus and subsequent abdominal distension.
Do Not Miss Diagnoses
- Perforated Viscus: A perforation in the gastrointestinal tract can lead to peritonitis, which may initially present with abdominal distension. This is a surgical emergency.
- Mesenteric Ischemia: Reduced blood flow to the intestines can cause ischemia, leading to abdominal pain and distension. Early diagnosis is crucial to prevent tissue death.
- Ovarian Torsion: In females, ovarian torsion can cause severe abdominal pain and potentially lead to abdominal distension due to associated nausea, vomiting, and decreased bowel movements.
- Ruptured Abdominal Aortic Aneurysm (AAA): Although more common in older adults with risk factors, a ruptured AAA can present with abdominal distension among other symptoms like severe back or abdominal pain.
Rare Diagnoses
- Abdominal Compartment Syndrome: Increased pressure within the abdominal cavity can impede blood flow and organ function, leading to distension. This is often seen in critically ill patients or after severe trauma.
- Pseudomyxoma Peritonei: A rare condition characterized by recurrent mucinous ascites causing abdominal distension, typically associated with a primary mucinous tumor of the appendix.
- Lymphoma or Other Abdominal Malignancies: Certain cancers can cause abdominal distension due to tumor growth, ascites, or bowel obstruction.