Differential Diagnosis for 15-year-old Female with Left Flank Pain
- Single most likely diagnosis
- Menstrual-related pain: Given that the patient is currently having her menstrual cycle, it's possible that the left flank pain is related to menstrual cramps or dysmenorrhea, which can radiate to the lower back or flanks.
- Other Likely diagnoses
- Constipation or bowel obstruction: Although the patient denies constipation and had a normal bowel movement yesterday, it's still possible that she has a bowel obstruction or constipation that's causing the flank pain.
- Musculoskeletal strain: The patient may have strained her back or flank muscles, leading to sharp and constant pain.
- Nephrolithiasis (kidney stones): Although the patient denies urinary frequency, urgency, or dysuria, it's still possible that she has a kidney stone that's causing the flank pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ectopic pregnancy: Although the patient is 15 and may not be sexually active, it's still possible that she is pregnant and has an ectopic pregnancy, which can cause severe flank pain and is a life-threatening condition.
- Ovarian torsion: Given the patient's history of vaginal atresia repair, she may be at increased risk for ovarian torsion, which can cause severe flank pain and is a surgical emergency.
- Appendicitis: Although the patient denies nausea, vomiting, and diarrhea, it's still possible that she has appendicitis, which can cause flank pain and is a surgical emergency.
- Rare diagnoses
- Inflammatory bowel disease (IBD): The patient's symptoms could be related to IBD, such as Crohn's disease or ulcerative colitis, which can cause flank pain and other gastrointestinal symptoms.
- Pancreatitis: Although the patient denies nausea and vomiting, it's still possible that she has pancreatitis, which can cause flank pain and is a serious condition.
- Retroperitoneal tumor: The patient may have a rare tumor in the retroperitoneal space that's causing the flank pain.