Differential Diagnosis for Diverticulitis

• Single most likely diagnosis
  • Diverticulitis: This is the most likely diagnosis given the presentation of diverticulitis, which typically includes abdominal pain (usually in the lower left quadrant), changes in bowel habits, and possible fever or nausea. The diagnosis is often confirmed by imaging studies such as CT scans.
• Other Likely diagnoses
  • Irritable Bowel Syndrome (IBS): Although IBS does not cause inflammation, its symptoms can sometimes mimic those of diverticulitis, such as abdominal pain and changes in bowel habits. However, IBS typically does not present with fever or significant weight loss.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause similar symptoms to diverticulitis, including abdominal pain, diarrhea, and weight loss. Differentiation often requires endoscopic examination and biopsy.
  • Gastroenteritis: Infections of the stomach and intestines can cause abdominal pain, diarrhea, and vomiting, which might be confused with diverticulitis. The presence of fever and the nature of the abdominal pain can help differentiate.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Appendicitis: Although the pain of appendicitis typically starts near the belly button and then moves to the lower right abdomen, in some cases, it can present similarly to diverticulitis, especially if the appendix is located in an unusual position. Missing appendicitis can lead to rupture and peritonitis.
  • Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can cause severe abdominal pain and internal bleeding, which could be mistaken for diverticulitis. This condition is life-threatening and requires immediate medical attention.
  • Bowel Obstruction: A blockage in the intestine can cause severe abdominal pain, constipation, and vomiting. If not treated promptly, it can lead to tissue death and perforation.
• Rare diagnoses
  • Epiploic Appendagitis: This is an inflammation of the epiploic appendages (small, fatty protrusions from the colon). It can cause acute abdominal pain that mimics diverticulitis but is typically less severe and resolves on its own.
  • Omental Infarction: Also known as omental thrombosis, this condition involves the death of tissue in the omentum (a layer of tissue that supports the intestines). It can cause severe abdominal pain and might be mistaken for diverticulitis or other abdominal conditions.
  • Mesenteric Ischemia: This condition involves a reduction in blood flow to the intestines, which can cause severe abdominal pain, bloody stools, and other symptoms that might be confused with diverticulitis. It is a medical emergency requiring prompt treatment.