Differential Diagnosis for 75-year-old Female with Right Abdominal Pain and Itchiness after Blood Draw
- Single Most Likely Diagnosis
- Cholecystitis: The presentation of right upper quadrant abdominal pain, especially after a procedure that may cause gallbladder contraction like a blood draw, suggests cholecystitis, which is inflammation of the gallbladder, often due to gallstones.
- Other Likely Diagnoses
- Biliary Colic: Pain from gallstones that have not yet caused an infection, which could be precipitated by the gallbladder contracting after a blood draw.
- Hepatitis: Could be a cause of both abdominal pain and itchiness, especially if the blood draw was contaminated or if the patient has a pre-existing liver condition.
- Pancreatitis: Inflammation of the pancreas, which could cause abdominal pain and potentially itchiness if there's an associated liver or biliary issue.
- Do Not Miss Diagnoses
- Liver or Bile Duct Cancer: Although less likely, these conditions can present with similar symptoms and would have a significant impact on prognosis if missed.
- Sphincter of Oddi Dysfunction: A condition that affects the sphincter controlling the flow of bile and pancreatic juices, which could cause recurrent biliary-type pain.
- Hemolytic Disease (e.g., Hemolytic Anemia): If the blood draw was complicated or if there's an underlying condition affecting red blood cells, this could lead to jaundice and itchiness.
- Rare Diagnoses
- Zollinger-Ellison Syndrome: A rare disorder characterized by excessive gastric acid production leading to peptic ulcers, which could cause abdominal pain.
- Porphyria: A group of disorders that can cause abdominal pain and neurological symptoms, including itchiness, though this is less common.
- Intra-abdominal Lymphoma: A rare cause of abdominal pain and could potentially cause itchiness if there's liver involvement or systemic symptoms.