Differential Diagnosis for 33-year-old Male with Abdominal Pain, Fevers, Vomiting, and Constipation
- Single most likely diagnosis:
- Intermittent Intestinal Obstruction: This condition is characterized by recurrent episodes of abdominal pain, vomiting, and constipation, which can occur due to various causes such as adhesions, hernias, or volvulus. The patient's history of similar episodes occurring about once a year supports this diagnosis.
- Other Likely diagnoses:
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause recurrent episodes of abdominal pain, fevers, and changes in bowel habits. The presence of constipation is less common in IBD, but it can occur, especially if the disease is limited to the distal colon.
- Irritable Bowel Syndrome (IBS): Although IBS typically does not cause fevers, some patients may experience intermittent episodes of severe abdominal pain, vomiting, and changes in bowel habits, including constipation.
- Chronic Intestinal Pseudo-Obstruction: This condition is characterized by recurrent episodes of intestinal obstruction without any mechanical blockage, leading to abdominal pain, vomiting, and constipation.
- Do Not Miss diagnoses:
- Appendicitis: Although the patient's symptoms have been recurring, it is essential to consider appendicitis, especially if the pain is localized to the right lower quadrant. A missed diagnosis of appendicitis can lead to severe complications, including perforation and peritonitis.
- Mesenteric Ischemia: This condition can cause severe abdominal pain, vomiting, and changes in bowel habits. It is essential to consider mesenteric ischemia, especially if the patient has risk factors such as atrial fibrillation or a history of vascular disease.
- Intussusception: This condition can cause intermittent episodes of abdominal pain, vomiting, and constipation, especially in adults with a lead point such as a tumor.
- Rare diagnoses:
- Familial Mediterranean Fever: This genetic disorder can cause recurrent episodes of abdominal pain, fevers, and inflammation, which may be accompanied by constipation.
- Eosinophilic Gastroenteritis: This rare condition can cause recurrent episodes of abdominal pain, vomiting, and changes in bowel habits, including constipation, due to eosinophilic infiltration of the gastrointestinal tract.
- Abdominal Migraine: This condition can cause recurrent episodes of abdominal pain, vomiting, and changes in bowel habits, including constipation, which may be accompanied by other migraine-like symptoms.