What is the cause of sudden onset severe abdominal pain, described as a continuous, intense, crampy pressure, rated 8/10, similar to a severe menstrual cramp (dysmenorrhea), that has gradually increased throughout the day and was partially alleviated by sitting in water?

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Differential Diagnosis for Sudden Front Abdominal Pain

  • Single most likely diagnosis:
    • Ovarian Cyst Rupture or Ovarian Torsion: The description of the pain as a bad period cramp with intense pressure, and the fact that sitting in water helped, suggests a gynecological origin. The sudden onset and gradual increase in pain severity are consistent with these conditions.
  • Other Likely diagnoses:
    • Kidney Stone: The severe, continuous pain could be indicative of a kidney stone, especially if the pain radiates to the back or groin. However, the description of the pain as similar to a period cramp and the relief from sitting in water makes this less likely.
    • Appendicitis: Although appendicitis typically presents with pain that initially is diffuse or around the navel and then localizes to the lower right abdomen, atypical presentations can occur, especially in women.
    • Urinary Tract Infection (UTI) or Pyelonephritis: These conditions can cause severe abdominal pain, but they are usually accompanied by other symptoms such as dysuria, frequency, or fever.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Ectopic Pregnancy: This is a life-threatening condition that must be considered in any woman of childbearing age presenting with sudden abdominal pain, especially if there's a possibility of pregnancy.
    • Ruptured Aortic Aneurysm: Although less common in younger individuals, a ruptured abdominal aortic aneurysm can present with severe, sudden abdominal pain and is immediately life-threatening.
    • Pulmonary Embolism: In some cases, pulmonary embolism can refer pain to the abdomen, especially if the embolism is large or involves the lung bases.
  • Rare diagnoses:
    • Endometriosis: While endometriosis can cause chronic pelvic pain, it's less likely to cause sudden, severe pain unless there's an acute complication like an endometrioma rupture.
    • Adrenal Gland Disorders: Certain adrenal gland disorders, such as a hemorrhage or tumor, can cause abdominal pain, but these are rare and usually have other associated symptoms.

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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