Differential Diagnosis for a Stone-like Specimen in Stool
- Single most likely diagnosis
- Gallstones: This is the most likely diagnosis because gallstones can pass through the digestive system and be excreted in the stool, especially if they are small enough. The presence of a stone-like specimen in the stool could indicate that a gallstone has passed from the gallbladder into the intestine and has been eliminated.
- Other Likely diagnoses
- Kidney stones: Although less common than gallstones being passed, it is possible for small kidney stones to pass through the urinary system and into the intestines, where they could potentially be excreted in the stool. However, this would typically be accompanied by significant urinary symptoms.
- Gastrointestinal bezoars: Bezoars are accumulations of swallowed material (like hair, plant fibers, or other indigestible materials) that can form a mass in the gastrointestinal tract. Over time, these masses can become hard and stone-like, potentially being passed in the stool.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intestinal foreign body: Although rare, the possibility of a foreign body (like a swallowed object) causing an obstruction or other serious complications cannot be overlooked. If the stone-like specimen is actually a foreign object, it could lead to severe intestinal damage or obstruction if not promptly addressed.
- Parasitic infections (e.g., tapeworm segments): Certain parasitic infections can cause the passage of structures that might resemble stones in the stool. Missing such a diagnosis could lead to ongoing infection and potential complications.
- Rare diagnoses
- Fecaliths: These are rare, stone-like formations within the intestine, often associated with chronic constipation or intestinal obstruction. They are composed of fecal material that has hardened over time.
- Enteroliths: These are stone-like formations that occur within the intestine, often around a nidus like a foreign body or a piece of food. They can cause intestinal obstruction if they become large enough.
- Coproliths: Similar to fecaliths, coproliths are hardened fecal masses that can form in the intestines, potentially being passed in the stool. They are associated with conditions that lead to fecal stasis.