Differential Diagnosis
- Single most likely diagnosis
- Dehydration or prerenal acute kidney injury (AKI): The elevated creatinine level (1.8) suggests impaired kidney function, which could be due to dehydration or prerenal causes. The presence of a few prominent distended loops of small bowel may indicate decreased bowel motility, which can be seen in dehydration.
- Other Likely diagnoses
- Gastroenteritis: The abdominal X-ray findings of a few prominent distended loops of small bowel and moderate colonic stool volume could be indicative of gastroenteritis, which may lead to dehydration and subsequent AKI.
- Early stages of bowel obstruction: Although the X-ray does not show an obstructive bowel gas pattern, the presence of distended loops of small bowel could be an early sign of bowel obstruction.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Mesenteric ischemia: This condition can present with nonspecific abdominal X-ray findings, and the presence of distended bowel loops could be an early sign. Mesenteric ischemia is a life-threatening condition that requires prompt diagnosis and treatment.
- Sepsis: Although the lung bases are clear, sepsis can present with nonspecific findings, and the elevated creatinine level could be indicative of sepsis-induced AKI.
- Rare diagnoses
- Intussusception: This condition can cause bowel obstruction and is more common in children, but can occur in adults. The abdominal X-ray findings could be suggestive of intussusception, although it is a rare diagnosis.
- Small bowel lymphoma or other malignancies: These conditions can cause bowel obstruction and impaired kidney function, although they are less likely given the lack of other specific findings.