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Last updated: August 27, 2025View editorial policy

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Differential Diagnosis for Distended Abdomen

Single Most Likely Diagnosis

  • Constipation: This is often the most common cause of a distended abdomen, especially in the elderly or those with a history of bowel habits that are not regular. Constipation leads to the accumulation of feces in the intestines, causing abdominal distension.

Other Likely Diagnoses

  • Irritable Bowel Syndrome (IBS): Characterized by abdominal pain, bloating, and changes in bowel movements, IBS can cause significant abdominal distension due to gas and fluid accumulation.
  • Ascites: The accumulation of fluid in the peritoneal cavity, often due to liver cirrhosis, can lead to marked abdominal distension.
  • Small Bowel Obstruction: A mechanical obstruction of the small intestine can cause abdominal distension, nausea, vomiting, and constipation.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal distension due to inflammation and possible obstruction.

Do Not Miss Diagnoses

  • Ovarian Torsion: Although less common, ovarian torsion is a surgical emergency that can present with acute abdominal pain and distension, particularly in women.
  • Ruptured Abdominal Aortic Aneurysm (AAA): A life-threatening condition that requires immediate surgical intervention, presenting with severe abdominal pain and possible distension.
  • Perforated Viscus: A hole in the wall of the stomach or intestine can lead to peritonitis, an infection of the abdominal cavity, which is a medical emergency.
  • Ectopic Pregnancy: In pregnant women, an ectopic pregnancy can cause abdominal distension and pain, and is a life-threatening condition if not promptly treated.

Rare Diagnoses

  • Lymphoma: Abdominal lymphoma can cause distension due to the accumulation of lymphatic fluid or the growth of tumor masses.
  • Tuberculosis: Abdominal tuberculosis can lead to ascites, bowel obstruction, and abdominal distension.
  • Cystic Fibrosis: In advanced stages, cystic fibrosis can cause intestinal obstruction and distal intestinal obstruction syndrome (DIOS), leading to abdominal distension.
  • Abdominal Lymphangioma: A rare benign tumor that can cause abdominal distension due to the accumulation of lymphatic fluid.

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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