Differential Diagnosis for 21 y/o Patient with Gastritis and Inability to Hold Down Food
- Single Most Likely Diagnosis
- Gastroenteritis: This is the most likely diagnosis given the patient's symptoms of not being able to hold anything down for the last three days, combined with sinus congestion and headache. The recent history of gastritis also supports this diagnosis, as it could be a flare-up or a complication of the existing condition.
- Other Likely Diagnoses
- Viral gastroenteritis: The symptoms of vomiting, sinus congestion, and headache could be indicative of a viral infection affecting the gastrointestinal tract.
- Food poisoning: Although the patient denies vomiting blood, food poisoning could still be a consideration, especially if the patient has recently consumed contaminated or spoiled food.
- Gastric ulcer disease: Given the patient's history of gastritis, there is a possibility that the patient could have developed a gastric ulcer, which could be causing the current symptoms.
- Do Not Miss Diagnoses
- Appendicitis: Although the patient's symptoms are primarily gastrointestinal, appendicitis can sometimes present with nausea, vomiting, and abdominal pain, and it is crucial not to miss this diagnosis due to its potential for serious complications.
- Intestinal obstruction: This is a serious condition that requires prompt medical attention. Although less likely, the patient's inability to hold down food and liquids could be indicative of an obstruction.
- Inflammatory bowel disease (IBD) flare: If the patient has a history of IBD (such as Crohn's disease or ulcerative colitis), a flare could be causing the current symptoms.
- Rare Diagnoses
- Gastric cancer: Although extremely rare in a 21-year-old, gastric cancer could be a consideration if the patient has a strong family history or other risk factors.
- Zollinger-Ellison syndrome: This rare disorder causes excessive gastric acid production, leading to severe gastrointestinal symptoms.
- Eosinophilic gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which could cause the patient's symptoms.