Differential Diagnosis for 77 year old male with abdominal pain
- The patient's symptoms of deep abdominal pain radiating to the left shoulder, diarrhea, and extreme tenderness to palpation can be caused by various conditions. Here is a categorized differential diagnosis:
Single most likely diagnosis
- Pancreatitis: The patient's pain radiating to the left shoulder and extreme tenderness to palpation are classic signs of pancreatitis, especially in an elderly patient. The diarrhea could be a secondary effect of the pancreatic inflammation.
Other Likely diagnoses
- Peptic Ulcer Disease: The patient's abdominal pain and tenderness could be due to a peptic ulcer, which can cause referred pain to the shoulder. The diarrhea could be a secondary effect of the ulcer or its treatment.
- Cholecystitis: Inflammation of the gallbladder can cause abdominal pain radiating to the shoulder and tenderness to palpation. The diarrhea could be a secondary effect of the inflammation.
- Diverticulitis: The patient's abdominal pain and tenderness could be due to diverticulitis, which can cause diarrhea and referred pain to the shoulder.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic Dissection: Although less likely, an aortic dissection can cause severe abdominal pain radiating to the shoulder and tenderness to palpation. This condition is life-threatening and requires immediate attention.
- Mesenteric Ischemia: This condition can cause abdominal pain and tenderness, and can be deadly if missed. The patient's age and symptoms make this a possibility, although less likely.
- Perforated Viscous: A perforated viscus can cause severe abdominal pain and tenderness, and can be deadly if missed. The patient's symptoms and age make this a possibility, although less likely.
Rare diagnoses
- Pneumococcal Peritonitis: This is a rare condition that can cause abdominal pain and tenderness, but is less likely in this patient.
- Carcinomatous Peritonitis: This is a rare condition that can cause abdominal pain and tenderness, but is less likely in this patient without a known history of cancer.