Differential Diagnosis for Abdominal Pain
The following differential diagnosis is organized into categories to help guide the thought process for a patient presenting with abdominal pain.
- Single Most Likely Diagnosis
- Acute Appendicitis: This is a common cause of abdominal pain, especially in younger patients, and is often characterized by pain that initially presents in the periumbilical region and then localizes to the right lower quadrant.
- Other Likely Diagnoses
- Gastroenteritis: Inflammation of the stomach and intestines, usually due to infection, which can cause abdominal pain, diarrhea, and vomiting.
- Urinary Tract Infection (UTI): Can cause abdominal pain, especially in the lower abdomen, along with symptoms like dysuria and frequent urination.
- Diverticulitis: Inflammation of the diverticula in the digestive tract, which can cause abdominal pain, usually in the lower left abdomen.
- Cholecystitis: Inflammation of the gallbladder, often due to gallstones, which can cause right upper quadrant abdominal pain.
- Do Not Miss Diagnoses
- Ectopic Pregnancy: A pregnancy that develops outside the uterus, which can cause abdominal pain and vaginal bleeding. Missing this diagnosis can be life-threatening.
- Ruptured Aortic Aneurysm: A serious condition where the aorta ruptures, causing severe abdominal pain and potentially leading to rapid death if not treated immediately.
- Intestinal Obstruction: A blockage that prevents normal flow of the products of digestion, which can cause severe abdominal pain, vomiting, and constipation.
- Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain, nausea, and vomiting.
- Rare Diagnoses
- Porphyria: A group of disorders that can cause abdominal pain, among other symptoms, due to a buildup of natural chemicals that produce porphyrin in the body.
- Henoch-Schönlein Purpura (HSP): A form of vasculitis that affects blood vessels and can cause abdominal pain, along with a characteristic rash.
- Abdominal Migraine: A condition that causes recurrent episodes of severe abdominal pain, often accompanied by other migraine symptoms like headache and nausea.
Each of these diagnoses has a unique set of symptoms and risk factors, and a thorough medical history, physical examination, and diagnostic tests are necessary to determine the underlying cause of abdominal pain in a patient.