Differential Diagnosis for Elderly Woman with Three Broken Ribs, Intense Abdominal Pain, and Lower Leg Swelling
- Single Most Likely Diagnosis
- Pulmonary embolism with associated trauma: This diagnosis is likely due to the combination of intense abdominal pain, lower leg swelling (possible deep vein thrombosis), and three broken ribs, which could be a source of pulmonary embolism.
- Other Likely Diagnoses
- Rib fracture with associated internal injury (e.g., splenic or liver laceration): The intense abdominal pain could be related to internal injuries caused by the broken ribs.
- Deep vein thrombosis (DVT) with pulmonary embolism: The lower leg swelling could indicate a DVT, which increases the risk of pulmonary embolism.
- Abdominal aortic aneurysm (AAA): AAA can cause intense abdominal pain and is more common in elderly individuals.
- Do Not Miss Diagnoses
- Aortic dissection: Although less likely, aortic dissection is a life-threatening condition that requires immediate attention. The intense abdominal pain and broken ribs could be related to a traumatic aortic dissection.
- Sepsis: Elderly individuals are more susceptible to sepsis, which can present with non-specific symptoms, including abdominal pain and swelling.
- Mesenteric ischemia: This condition can cause intense abdominal pain and is more common in elderly individuals with cardiovascular disease.
- Rare Diagnoses
- Osteoporotic vertebral fracture with referred abdominal pain: Although less likely, osteoporotic vertebral fractures can cause referred abdominal pain and are common in elderly individuals.
- Spontaneous hemoperitoneum: This rare condition can cause intense abdominal pain and is more common in individuals with bleeding disorders or on anticoagulant therapy.