Differential Diagnosis for Abdominal Pain

Based on the provided laboratory and radiographic results, the following differential diagnoses are considered:

• Single Most Likely Diagnosis
  • Constipation: The patient's symptoms of severe abdominal pain, nausea, and no bowel movement for days immediately following pain onset, combined with the radiographic finding of moderate fecal load, suggest constipation as the most likely diagnosis. The patient's history of a similar episode in 2024 also supports this diagnosis.
• Other Likely Diagnoses
  • Intestinal Obstruction: The patient's symptoms of severe abdominal pain and no bowel movement for days could also suggest an intestinal obstruction. However, the radiographic findings do not show any evidence of obstruction, such as dilated bowel loops or air-fluid levels.
  • Inflammatory Bowel Disease: The patient's elevated C-reactive protein (CRP) and history of similar episodes could suggest an inflammatory bowel disease, such as Crohn's disease or ulcerative colitis.
  • Gastroenteritis: The patient's symptoms of abdominal pain, nausea, and moderate fecal load could also suggest gastroenteritis, although the lack of fever, vomiting, or diarrhea makes this diagnosis less likely.
• Do Not Miss Diagnoses
  • Appendicitis: Although the patient's symptoms and radiographic findings do not strongly suggest appendicitis, it is a potentially life-threatening condition that should not be missed. The patient's severe abdominal pain and elevated CRP warrant consideration of this diagnosis.
  • Diverticulitis: The patient's age and symptoms of abdominal pain and nausea could suggest diverticulitis, although the radiographic findings do not show any evidence of diverticula or inflammation.
  • Bowel Ischemia: The patient's severe abdominal pain and elevated CRP could also suggest bowel ischemia, although the radiographic findings do not show any evidence of ischemia or infarction.
• Rare Diagnoses
  • Intussusception: The patient's symptoms of abdominal pain and no bowel movement for days could suggest intussusception, although this diagnosis is rare in adults and the radiographic findings do not show any evidence of intussusception.
  • Volvolus: The patient's symptoms of abdominal pain and nausea could suggest a volvulus, although this diagnosis is rare and the radiographic findings do not show any evidence of volvulus.
  • Mesenteric Panniculitis: The patient's elevated CRP and symptoms of abdominal pain could suggest mesenteric panniculitis, although this diagnosis is rare and the radiographic findings do not show any evidence of panniculitis.