Differential Diagnosis for 79 YOF with Middle Abdominal Pain and Vomiting
- Single most likely diagnosis:
- Small bowel obstruction: This is a common cause of middle abdominal pain and vomiting, especially in elderly patients. The inability to keep down liquids or oral medication suggests a possible obstruction.
- Other Likely diagnoses:
- Gastroenteritis: Viral or bacterial infection can cause abdominal pain, vomiting, and dehydration, which may be severe in elderly patients.
- Mesenteric ischemia: Reduced blood flow to the intestines can cause abdominal pain, vomiting, and may lead to bowel infarction if not promptly treated.
- Diverticulitis: Inflammation of the diverticula in the colon can cause abdominal pain, vomiting, and may lead to complications such as abscess or perforation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Appendicitis: Although less common in elderly patients, appendicitis can present with atypical symptoms and may lead to perforation and peritonitis if not promptly treated.
- Perforated viscus: A hole in the stomach or intestine can cause severe abdominal pain, vomiting, and may lead to peritonitis and sepsis if not promptly treated.
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain, vomiting, and may lead to complications such as necrotizing pancreatitis or pseudocyst formation.
- Rare diagnoses:
- Intussusception: A condition where a part of the intestine telescopes into another part, causing obstruction and potentially leading to bowel infarction.
- Volvolus: A twisting of the intestine that can cause obstruction and potentially lead to bowel infarction.
- Abdominal aortic aneurysm: A rupture of the aortic aneurysm can cause severe abdominal pain, vomiting, and may lead to shock and death if not promptly treated.