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Differential Diagnosis

  • Single most likely diagnosis:
    • Ovarian cyst or corpus luteum cyst: The patient's symptoms of left-sided pelvic pain and the ultrasound finding of a corpus luteum that didn't look strong enough to support a pregnancy could be consistent with a ruptured or persistent corpus luteum cyst. The pain under the left ribcage could be referred pain or due to bloating. The fact that the patient got her period on October 21st also supports this diagnosis, as it suggests that the corpus luteum was not supporting a pregnancy.
  • Other Likely diagnoses:
    • Mild pelvic inflammatory disease (PID) or salpingitis: The thickened left fallopian tube on ultrasound could be a sign of inflammation, and the patient's symptoms of pelvic pain could be consistent with PID. However, the lack of signs of infection and the normal ultrasound findings make this less likely.
    • Ovarian torsion: Although the patient's symptoms of pelvic pain could be consistent with ovarian torsion, the fact that the ultrasound did not show any signs of torsion and the patient's symptoms improved with time make this less likely.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Ectopic pregnancy: Although the patient's physician told her that it's probably not an ectopic pregnancy, it's essential to consider this diagnosis, especially given the patient's symptoms of pelvic pain and the thickened fallopian tube on ultrasound. The fact that the ultrasound did not show a clear ectopic pregnancy does not rule out this diagnosis entirely.
    • Ruptured ovarian cyst: A ruptured ovarian cyst can cause severe pelvic pain and can be life-threatening if not treated promptly.
  • Rare diagnoses:
    • Endometriosis: The patient's symptoms of pelvic pain could be consistent with endometriosis, although this would not explain the thickened fallopian tube on ultrasound.
    • Diverticulitis or other gastrointestinal causes: The patient's symptoms of pain under the left ribcage could be consistent with a gastrointestinal cause, although this would not explain the pelvic pain and ultrasound findings.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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