Differential Diagnosis for Bilateral Lower Abdominal Pain in a Male in his 30s
Single Most Likely Diagnosis
- Musculoskeletal strain: Given the age and presentation of bilateral lower abdominal pain, a musculoskeletal strain from overuse or injury is a common and plausible cause. This could be due to physical activity, heavy lifting, or even poor posture.
Other Likely Diagnoses
- Urinary tract infection (UTI): Although less common in men than in women, UTIs can cause lower abdominal pain and should be considered, especially if there are accompanying symptoms like dysuria or frequency.
- Inguinal hernia: Hernias can cause pain in the lower abdomen, especially if they become incarcerated or strangulated, which would be an emergency.
- Prostatitis: Inflammation of the prostate gland can cause lower abdominal pain, pelvic pain, and sometimes urinary symptoms.
- Diverticulitis: Although more common in older adults, diverticulitis (inflammation of the diverticula in the digestive tract) can occur in younger individuals and cause lower abdominal pain, usually on the left side.
Do Not Miss Diagnoses
- Testicular torsion: A medical emergency that requires immediate attention. It presents with sudden, severe testicular pain, which can radiate to the lower abdomen. Early diagnosis and treatment are crucial to save the testicle.
- Appendicitis: Although appendicitis typically presents with right lower quadrant pain, it can sometimes present atypically, especially if the appendix is in a retrocecal position. It's a surgical emergency if not promptly treated.
- Ectopic pregnancy (in a female partner, if applicable): If the patient is sexually active and his partner is experiencing similar symptoms, ectopic pregnancy should be considered as it is a life-threatening condition.
- Ruptured abdominal aortic aneurysm: This is a rare but life-threatening condition that can cause severe abdominal pain and should be considered, especially in patients with risk factors like smoking or hypertension.
Rare Diagnoses
- Lymphoma: Certain types of lymphoma can cause abdominal pain due to lymph node enlargement or other complications.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, which can cause abdominal pain, usually intermittent, and is more common in children but can occur in adults.
- Ovarian torsion (in a female partner, if applicable): Similar to testicular torsion, ovarian torsion is a gynecologic emergency that requires immediate attention.
- Mesenteric ischemia: A condition where there's insufficient blood flow to the intestines, which can cause severe abdominal pain and is more common in older adults or those with cardiovascular risk factors.