Differential Diagnosis for Abdominal Pain with No Exam Findings
Single Most Likely Diagnosis
- Functional abdominal pain: This is the most likely diagnosis, as the patient reports abdominal pain but has no findings on exam. Functional abdominal pain is a common condition characterized by recurring abdominal pain that is not explained by other medical conditions.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): IBS is a common condition that can cause abdominal pain, bloating, and changes in bowel movements. The lack of exam findings does not rule out IBS, as it is a functional disorder.
- Gastroesophageal Reflux Disease (GERD): GERD can cause abdominal pain, particularly in the upper abdomen, and may not have any specific findings on exam.
- Constipation: Constipation is a common condition that can cause abdominal pain, and the lack of exam findings does not rule it out.
Do Not Miss Diagnoses
- Appendicitis: Although the patient has no exam findings, appendicitis is a serious condition that requires prompt diagnosis and treatment. Early appendicitis may not have significant exam findings, and a high index of suspicion is necessary.
- Ectopic pregnancy: Ectopic pregnancy is a life-threatening condition that can cause abdominal pain, and the lack of exam findings does not rule it out. A pregnancy test and imaging studies may be necessary to rule out this condition.
- Intestinal obstruction: Intestinal obstruction is a serious condition that can cause abdominal pain, and the lack of exam findings does not rule it out. Imaging studies and further evaluation may be necessary to diagnose this condition.
Rare Diagnoses
- Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): These conditions can cause abdominal pain, but are less common than other diagnoses on this list.
- Abdominal malignancy: Abdominal malignancy is a rare cause of abdominal pain, but should be considered in patients with persistent or severe symptoms.
- Porphyria: Porphyria is a rare genetic disorder that can cause abdominal pain, and the lack of exam findings does not rule it out.
Note: The percentage of risk for appendicitis in a patient with abdominal pain but no exam findings is difficult to quantify, as it depends on various factors, including the patient's overall clinical presentation, laboratory results, and imaging studies. However, it is estimated that the risk of appendicitis in patients with abdominal pain is around 5-10%.