Differential Diagnosis for Abdominal Pains

Abdominal pain is a common symptom with a wide range of possible causes. The differential diagnosis can be organized into the following categories:

• Single Most Likely Diagnosis
  • Gastroenteritis: This is often the most common cause of abdominal pain, especially if the pain is accompanied by symptoms like diarrhea, vomiting, and fever. It's usually caused by a viral or bacterial infection.
• Other Likely Diagnoses
  • Irritable Bowel Syndrome (IBS): A chronic condition characterized by abdominal pain, bloating, and changes in bowel movements. It's a common cause of chronic abdominal pain.
  • Constipation: Can cause significant abdominal pain and discomfort, often accompanied by bloating and difficulty passing stools.
  • Peptic Ulcer Disease: Includes both gastric and duodenal ulcers, which can cause abdominal pain, especially in the upper abdomen, and can be exacerbated by food.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic abdominal pain, diarrhea, weight loss, and sometimes blood in the stool.
• Do Not Miss Diagnoses
  • Appendicitis: Although not the most common cause, appendicitis is a medical emergency that requires prompt surgical intervention. It typically presents with severe abdominal pain that initially might be diffuse but often localizes to the right lower quadrant.
  • Ectopic Pregnancy: A life-threatening condition where the embryo implants outside the uterus, often presenting with abdominal pain and vaginal bleeding in a woman of childbearing age.
  • Ruptured Aortic Aneurysm: A medical emergency that can present with severe, tearing abdominal pain and is often associated with hypotension.
  • Mesenteric Ischemia: A condition where there's insufficient blood flow to the intestines, which can cause severe abdominal pain out of proportion to the physical examination findings.
• Rare Diagnoses
  • Intussusception: A condition where a part of the intestine slides into an adjacent part, which can cause abdominal pain, vomiting, and bloody stools. It's more common in children but can occur in adults.
  • Pancreatic Cancer: Although rare, it can present with abdominal pain, weight loss, and jaundice.
  • Gallbladder Disease: Including cholecystitis and cholelithiasis, which can cause right upper quadrant abdominal pain, especially after eating fatty foods.
  • Hernias: Can cause abdominal pain and a palpable mass, especially if they become incarcerated or strangulated.

Each of these diagnoses has distinct features and risk factors, and a thorough history, physical examination, and sometimes diagnostic tests are necessary to determine the cause of abdominal pain.