Differentials

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Usually presents with right lower quadrant pain, fever, and signs of peritonitis.

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Urinalysis is negative.

Non-contrast helical computed tomography scan (NCCT) shows dilation of appendix and absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Woman of childbearing age presents with missed menstrual period, right lower quadrant pain, or pelvic pain with some degree of vaginal bleeding or spotting. Cervical motion tenderness may be present on pelvic examination.

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Urine pregnancy test is positive and serum hCG elevated.

Ultrasound reveals presence of mass in fallopian tubes.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

May present with lower pelvic/abdominal discomfort and/or dyspareunia; may be cyclical.

Palpable mass on pelvic examination.

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Abdominal ultrasound shows cystic adnexal lesion; free fluid in the peritoneum.

NCCT shows absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

May present with left lower quadrant pain or abdominal pain as opposed to flank pain.

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Technetium pertechnetate scan may show enhancement of diverticulum if gastric mucosa is present.

NCCT shows absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Bowel obstruction patients present with abdominal distension, vomiting, and constipation.

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Abdominal x-ray may show volvulus.

NCCT shows collapsed bowel with proximal dilation and absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

History of gallstones or alcohol abuse.

These patients typically have epigastric pain that radiates to the back, as opposed to flank pain.

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NCCT shows inflammation of the pancreas and absence of renal stones.

The diagnosis of pancreatitis can usually be distinguished from renal stones on clinical grounds, but in rare cases it might be necessary to measure serum amylase and lipase, which are raised in pancreatitis and usually normal in stone disease.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

May or may not have a history of peptic ulcer disease. Pain is abrupt, severe in intensity, and may be localised to right lower quadrant; often related to eating meals.

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Erect chest x-ray and abdominal x-ray may show free air under the diaphragm.

Endoscopy shows peptic ulcer.

NCCT shows absence of renal stones.

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SIGNS / SYMPTOMS

These patients typically have diffuse abdominal pain and no flank pain. Vomiting is prominent and patient may have diarrhoea.

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Stool specimen may be positive for culture.

NCCT shows absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Pain typically presents as sudden onset of intermittent or continuous abdominal pain, radiating to the back; patient may collapse.

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Ultrasound/CT of the abdomen can show the presence of abdominal aortic aneurysm.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patients may present with costovertebral angle tenderness and urinary symptoms of dysuria, frequency, and hesitancy; flank pain may radiate to back; fever, chills, fatigue may be present.

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Positive urinalysis and/or urine culture.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patients typically present with acute lower abdominal pain, fevers, and vaginal discharge.

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Pelvic ultrasound shows multilocular adnexal masses.

NCCT shows thick-walled rim-enhancing adnexal masses in the absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patients may present with intermittent flank or abdominal pain, often worse during brisk diuresis.

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Renal ultrasound or NCCT shows hydronephrosis without a dilated ureter in the absence of a renal stone.

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SIGNS / SYMPTOMS

Patients typically present with lower abdominal pain, scrotal pain (testicle), nausea, and/or vomiting.

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Ultrasound shows enlarged, heterogeneous testicle with decreased or absent Doppler flow.

NCCT shows enlarged oedematous testicle in absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patients typically present with lower abdominal pain, nausea, and/or vomiting.

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Ultrasound shows enlarged, heterogeneous ovary with decreased or absent Doppler flow.

NCCT shows enlarged oedematous ovary in absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patient may present with unilateral or bilateral middle and/or lower back pain.

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Point tenderness upon muscular palpation.

NCCT is normal with absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patients typically present with acute peri-umbilical abdominal pain with nausea and vomiting.

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NCCT shows bowel wall thickening, intestinal pneumatosis, portal venous gas, with absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patients typically present with left lower quadrant pain and abdominal distension.

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NCCT shows excessive stool in colon or rectum in absence of renal stones.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Patient may present with right upper quadrant and/or epigastric pain, fevers, and leukocystosis.

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Abdominal ultrasound will show gallstones with gallbladder wall thickening.

NCCT shows gallstones, gallbladder wall oedema, and high attenuation bile in the absence of renal stones.

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