Differential Diagnosis for 41-year-old with Left Lower Quadrant Pain
- Single most likely diagnosis
- Diverticulitis: The patient's symptoms of severe left lower quadrant pain, fever, and changes in bowel habits (passing gas, small BMs) are consistent with diverticulitis, which is an inflammation of the diverticula in the colon. The localized pressure and stiffness to the lateral side of the back also support this diagnosis.
- Other Likely diagnoses
- Constipation: Although the patient reports having two small BMs, the feeling of gassy pressure and stiffness could also be indicative of constipation, especially if the patient is not fully evacuating their bowels.
- Irritable Bowel Syndrome (IBS): The abdominal pain, changes in bowel habits, and feeling of gassy pressure could be symptoms of IBS, although the severity of the pain and the presence of a fever make this less likely.
- Kidney Stone: The severe pain and stiffness in the back could be indicative of a kidney stone, although the lack of urinary symptoms makes this less likely.
- Do Not Miss diagnoses
- Appendicitis: Although the pain is in the left lower quadrant, appendicitis can sometimes present with pain in this location, especially if the appendix is retrocecal. The severity of the pain and the presence of a fever make it essential to consider this diagnosis.
- Ectopic Pregnancy: Although the patient does not report any vaginal bleeding or other symptoms of pregnancy, an ectopic pregnancy can present with severe abdominal pain and fever, making it a critical diagnosis not to miss.
- Ovarian Torsion: The severe pain and stiffness in the back could be indicative of ovarian torsion, which is a medical emergency.
- Rare diagnoses
- Inflammatory Bowel Disease (IBD): The patient's symptoms could be indicative of IBD, such as Crohn's disease or ulcerative colitis, although these conditions are less common and typically have a more gradual onset.
- Intussusception: The abdominal pain and changes in bowel habits could be symptoms of intussusception, which is a rare condition where a part of the intestine telescopes into another part.
- Colonic Volvulus: The severe abdominal pain and changes in bowel habits could be indicative of a colonic volvulus, which is a rare condition where the colon twists on itself.