Differential Diagnosis for Free Liquid in the Epigastric Region
- Single Most Likely Diagnosis
- Peptic ulcer disease: This is a common cause of free fluid in the epigastric region, often due to perforation of a gastric or duodenal ulcer, leading to leakage of stomach contents into the abdominal cavity.
- Other Likely Diagnoses
- Pancreatitis: Inflammation of the pancreas can cause fluid accumulation in the epigastric region, either due to the inflammatory process itself or due to pancreatic duct disruption.
- Gastritis: Severe inflammation of the stomach lining can lead to fluid leakage into the abdominal cavity.
- Liver disease (e.g., cirrhosis): Can cause ascites, which may accumulate in the epigastric region.
- Do Not Miss Diagnoses
- Ruptured abdominal aortic aneurysm: Although less common, this is a life-threatening condition that requires immediate attention. Free fluid in the epigastric region could be a sign of internal bleeding.
- Ectopic pregnancy: In women of childbearing age, a ruptured ectopic pregnancy can cause free fluid in the abdominal cavity, including the epigastric region.
- Splenic rupture: Trauma to the spleen can cause it to rupture, leading to internal bleeding and free fluid accumulation.
- Rare Diagnoses
- Mesenteric cyst: A rare congenital or acquired condition where a cyst forms in the mesentery, which can rupture and cause free fluid.
- Internal hernia: Although rare, internal hernias can cause bowel obstruction and subsequent fluid accumulation.
- Abdominal tuberculosis: In areas where tuberculosis is common, abdominal involvement can lead to fluid accumulation, including in the epigastric region.