Differential Diagnosis for Patient with Mild Abdominal Pain, Nausea, Vomiting, Negative Abdominal CT, High White Count, and Septic Vitals
- Single Most Likely Diagnosis
- Appendicitis: Despite a negative abdominal CT, appendicitis remains a high consideration due to the clinical presentation of abdominal pain, nausea, vomiting, and elevated white blood cell count. Early appendicitis or a retrocecal appendix might not be visible on CT.
- Other Likely Diagnoses
- Diverticulitis: Although the CT was negative, diverticulitis, especially if it's early or limited, might not show clear signs on imaging. The symptoms and elevated white count support this possibility.
- Gastroenteritis: Could present with similar symptoms, including abdominal pain, nausea, vomiting, and an elevated white count if there's a significant inflammatory response.
- Mesenteric Lymphadenitis: Often mimics appendicitis and can have a similar presentation, including abdominal pain and elevated white blood cell count.
- Do Not Miss Diagnoses
- Mesenteric Ischemia: This is a critical diagnosis to consider due to its high mortality rate if not promptly treated. The presence of septic-looking vitals and abdominal pain, despite a negative CT, warrants consideration of this diagnosis.
- Ectopic Pregnancy: In women of childbearing age, ectopic pregnancy must be ruled out, as it can present with abdominal pain and vomiting, and a negative CT does not exclude this diagnosis.
- Intestinal Obstruction: Can lead to severe consequences if not addressed promptly. Early obstruction might not show significant findings on CT, especially if it's a partial obstruction.
- Rare Diagnoses
- Intussusception: More common in children but can occur in adults, often with a lead point such as a tumor. It can cause abdominal pain, nausea, and vomiting.
- Ovarian Torsion: Another rare but critical diagnosis in women, which can present with acute abdominal pain and vomiting.
- Primary Epiploic Appendagitis: A rare condition that can mimic appendicitis or diverticulitis, often resolving on its own but can cause significant pain and elevated inflammatory markers.