Differential Diagnosis for RLQ Pain and Abnormal Lab Results
Single Most Likely Diagnosis
- Appendicitis: The patient's presentation of right lower quadrant (RLQ) pain, nausea, vomiting, and diarrhea (N/V/D) is classic for appendicitis. The elevated total bilirubin (bili) of 4.1 may indicate a mild liver dysfunction or a reaction to the infection.
Other Likely Diagnoses
- Gastroenteritis: The symptoms of N/V/D could be indicative of a gastrointestinal infection, which might also cause RLQ pain due to the involvement of the intestines.
- Intestinal Obstruction: Although less common, an intestinal obstruction could cause similar symptoms, including pain, nausea, vomiting, and changes in bowel habits.
- Mesenteric Lymphadenitis: This condition, often caused by a viral or bacterial infection, can mimic appendicitis with RLQ pain and gastrointestinal symptoms.
Do Not Miss Diagnoses
- Ectopic Pregnancy: Although less likely in patients without a clear history of pregnancy or menstrual irregularities, ectopic pregnancy can present with RLQ pain and must be considered, especially in female patients of childbearing age.
- Ovarian Torsion: This is a surgical emergency that can cause severe RLQ pain and must be ruled out, particularly in female patients.
- Diverticulitis: While more common in the left lower quadrant, diverticulitis can occasionally present in the right lower quadrant and should be considered, especially in older patients.
Rare Diagnoses
- Meckel's Diverticulitis: A rare condition where a congenital anomaly of the small intestine becomes inflamed, causing symptoms similar to appendicitis.
- Hernias (Inguinal or Femoral): Although not typically associated with elevated bilirubin, a hernia could cause RLQ pain if it becomes incarcerated or strangulated.
- Yersinia or Campylobacter Infection: Certain bacterial infections can cause symptoms mimicking appendicitis, including RLQ pain and gastrointestinal disturbances.