Differential Diagnosis for 56-year-old Female with Lower Abdominal Pain
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The presence of leukocytes (leuk) and red blood cells (RBC) in the urine, along with lower abdominal pain, suggests a UTI. However, the absence of nitrites and the specific location of the pain could also point towards other diagnoses.
Other Likely Diagnoses
- Constipation: Given the patient has not had a bowel movement in 2 days, constipation could be causing the abdominal pain. The absence of stool could lead to a buildup of pressure, potentially causing pain.
- Diverticulitis: This condition involves inflammation of the diverticula in the digestive tract, often presenting with lower abdominal pain, and could be considered given the patient's age and symptoms.
- Ovarian Cyst: Although less common, an ovarian cyst could cause lower abdominal pain and could potentially rupture, leading to more severe symptoms.
Do Not Miss Diagnoses
- Appendicitis: Although the pain is described as lower abdominal, appendicitis can sometimes present with pain in this area, especially if the appendix is located in a retrocecal position. Missing this diagnosis could lead to severe consequences, including perforation and peritonitis.
- Ectopic Pregnancy: Although less likely given the patient's age, an ectopic pregnancy is a life-threatening condition that must be considered in any female patient of childbearing age presenting with lower abdominal pain.
- Kidney Stone: The presence of RBC in the urine could indicate a kidney stone, which would require prompt treatment to prevent complications such as obstruction or infection.
Rare Diagnoses
- Endometriosis: This condition, where tissue similar to the lining inside the uterus grows outside of it, can cause lower abdominal pain, especially during menstruation. However, it's less likely in a 56-year-old female due to the typical age of presentation.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis could present with abdominal pain and changes in bowel habits, but they are less common and would typically have other associated symptoms.