Inflammatory bowel disease differential diagnosis

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Inflammatory Bowel Disease Main page

Patient Information

Overview

Causes

Classification

Crohn's disease
Ulcerative colitis

Differential Diagnosis

Overview

Inflammatory bowel disease must be differentiated from other diseases that cause lower abdominal pain and fever like appendicitis, diverticulitis, colon cancer, cystitis, and endometritis.

Differentiating inflammatory bowel disease from other diseases

Inflammatory bowel disease must be differentiated from other diseases that cause lower abdominal pain and fever like appendicitis, diverticulitis, colon cancer, cystitis, and endometritis.[1][2][3][4][5][6]

Diseases Symptoms Signs Diagnosis Comments
Abdominal pain Bowel habits Rebound tenderness Guarding Genitourinary signs Lab findings Imaging
GI diseases Inflammatory bowel disease LLQ Bloody diarrhea - - -
  • Leukocytosis
 Colonoscopy and tissue sampling are recommended for differentiating between Crohn's disease and ulcerative colitis.
Diverticulitis LLQ Constipation

Or

Diarrhea

- + + CT scan shows evidence of inflammation
Appendicitis LLQ / RRQ Constipation + + - Ultrasound shows evidence of inflammation Nausea & vomiting,decreased appetite
Colon carcinoma LLQ Constipation - - - CT scan, x-ray and MRI used to show metastasis
Strangulated hernia LLQ - - - -
  • No specific tests
  • CT scan used to detect the hernia and to show if it is single or multiple
Gentiourinary diseases Cystitis LLQ - + -
  • Suprapubic tenderness
  • X ray is done to probe the suspicion of emphysematous cystitis.
  • CT scan shows gas in the bladder in cases of emphysematous cystitis.
Prostatitis LLQ

Groin pain

- - -
  • Tender and enlarged
Pelvic inflammatory disease Bilateral - + -
  • Purulent vaginal discharge
 Transvaginal utrasonography
Gynecological diseases Endometritis LLQ - + - +
  • No specific tests
  • Ultrasound is helpful to rule out other differential diagnosis such as pelvic abscess, thrombosis and masses
  • Vaginal discharge
  • Vaginal bleeding
Salpingitis LLQ/ RLQ +/- +/-
  • Leukocytosis
 Pelvic ultrasound
  • Vaginal discharge

References

  1. ↑ Laurell H, Hansson LE, Gunnarsson U (2007). "Acute diverticulitis--clinical presentation and differential diagnostics". Colorectal Dis. 9 (6): 496–501, discussion 501-2. doi:10.1111/j.1463-1318.2006.01162.x. PMID 17573742.
  2. ↑ Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034
  3. ↑ Hanauer SB (1996). "Inflammatory bowel disease". N Engl J Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552.
  4. ↑ Cystitis-acute. MedlinePlus.https://www.nlm.nih.gov/medlineplus/ency/article/000526.htm Accessed on February 9, 2016
  5. ↑ Prostatitis - bacterial. NLM Medline Plus 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed on March 2, 2016
  6. ↑ Ford GW, Decker CF (2016). "Pelvic inflammatory disease". Dis Mon. 62 (8): 301–5. doi:10.1016/j.disamonth.2016.03.015. PMID 27107781.
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