Inflammatory bowel disease differential diagnosis

Inflammatory Bowel Disease Main page

Patient Information

Overview

Causes

Classification

Crohn's disease
Ulcerative colitis

Differential Diagnosis

## Overview

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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

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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

Diarrhea

| \-  | \+  | \+  |

* Leukocytosis

| CT scan shows evidence of inflammation |
Appendicitis | LLQ / RRQ  | Constipation  | \+  | \+  | \-  |

* Leukocytosis

| Ultrasound shows evidence of inflammation | Nausea & vomiting,decreased appetite
Colon carcinoma | LLQ  | Constipation  | \-  | \-  | \-  |

* Serum carcino-embryogenic antigen
* Low Vit b12
* Hypercalcemia

| 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

* Pyuria
* Presence of nitrites and leukocyte estrase

* 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

* Serum PSA elevated
* Leukocytosis
* Elevated CRP

* CT scan shows edema and enlarged prostate
* Abscess may be observed

Pelvic inflammatory disease | Bilateral  | \-  | \+  | \-  |

* Purulent vaginal discharge

* Nucleic acid amplification tests is the best laboratory test for PID.

| 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

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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.CS1 maint: Multiple names: authors list (link)
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.