Appendicitis: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Diabetes mellitus (diabetes).
  • Food intolerances such as lactose intolerance, fructose intolerance.
  • Porphyria or acute intermittent porphyria (AIP); genetic disease with autosomal dominant inheritance; patients with this disease have a 50 percent reduction in the activity of the enzyme porphobilinogen deaminase (PBG-D), which is sufficient for porphyrin synthesis. Triggers of a porphyria attack, which can last a few days but also months, are infections, drugs or alcohol. The clinical picture of these attacks presents as acute abdomen or neurological deficits, which can take a lethal course. The leading symptoms of acute porphyria are intermittent neurologic and psychiatric disturbances. Autonomic neuropathy is often prominent, causing abdominal colic (acute abdomen), nausea (nausea), vomiting, or constipation (constipation), as well as tachycardia (heartbeats > 100 beats/min) and labile hypertension (high blood pressure).

Cardiovascular system (I00-I99).

  • Aortic aneurysm – formation of a wall bulge in the aorta that can rupture (burst).
  • Pulmonary embolism – pulmonary infarction occurring due to acute occlusion of pulmonary vessels.
  • Myocardial infarction (heart attack)

Infectious and parasitic diseases (A00-B99).

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Acute cholecystitis (gallbladder inflammation).
  • Colitis indeterminata – disease that is a combination of ulcerative colitis and Crohn’s disease.
  • Diversion colitis – disease occurring after surgical immobilization of intestinal segments.
  • Diverticulitis – inflammation of diverticula, which are protrusions of mucosa through muscle gaps in the intestinal wall.
  • Ileus (intestinal obstruction)
  • Infectious colitis – inflammation of the intestine caused by bacteria, viruses or parasites such as salmonella, yersinia, etc.
  • Ischemic colitis – inflammation of the intestine due to insufficient supply of nutrients and oxygen to the intestine.
  • Gastric/intestinal ulceration (ulcers)
  • Meckel’s diverticulitis – inflammation of an outpouching in the area of the small intestine, which is developmental remnant.
  • Mesenteric infarction – occlusion of vessels supplying part of the intestine.
  • Microscopic colitis or microscopic colitis (synonyms: collagenous colitis; collagen colitis, collagen colitis) – chronic, somewhat atypical inflammation of the mucosa of the colon (large intestine), the cause of which is unclear and which is clinically accompanied by violent watery diarrhea (diarrhea)/4-5 times a day, even at night; some patients suffer from abdominal pain (abdominal pain) in addition; 75-80% are women/females > 50 years of age; correct diagnosis is only possible with colonoscopy (colonoscopy) and step biopsies (taking tissue samples in the individual sections of the colon), i.e. i.e. by a histological (fine tissue) examination to put.
  • Crohn’s diseasechronic inflammatory bowel disease (CED); usually runs in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, it may be affected several intestinal sections, which are separated from each other by healthy sections.
  • Whipple’s disease – quite rare disease of the small intestine, caused by the bacterium Tropheryma whipplei from the group of actinomycetes.
  • Food allergy
  • Rectal ulcer (rectal ulcer)
  • Irritable bowel syndrome (colon irritable)
  • Radiation colitis – disease that can occur after radiation, especially in the context of cancer therapy.
  • Pedunculated ovarian cystwater-filled tumor in the region of the ovary whose supplying vessels have been pinched off.

Musculoskeletal system and connective tissue (M00-M99).

  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the ray body (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected

Neoplasms – tumor diseases (C00-D48).

  • Adenocarcinomas* (60.4%)
  • Familial adenomatous polyposis (FAP; synonym: familial polyposis) – is an autosomal dominant inherited disorder. This leads to the occurrence of a large number (> 100 to thousands) of colorectal adenomas (polyps). The probability of malignant (malignant) degeneration is almost 100% (average from the age of 40).
  • Lymphoma* (2.1%) – malignant disease originating in the lymphatic system.
  • Neuroendocrine tumors* (37, 5%).
  • Pancreatic carcinoma (cancer of the pancreas).

* Malignant (malignant) appendicitis cause; risk factors include older age (56 vs. 37 years), longer symptoms (36-41 vs. 18-23 hours) and more frequent phlegmonous (“spreading under the clinical picture of phlegmon/diffuse infectious disease of the soft tissues”) changes on imaging; independent risk factor is the diameter of the appendix (appendix) on computed tomography (CT): for each additional millimeter in diameter, the probability of malignancy (cancer) increased by 6%; over age 40, a diameter of more than 1 cm means a malignancy risk (risk of malignancy) of about 3%. Pregnancy, childbirth, and puerperium (O00-O99).

  • Extrauterine pregnancy – implantation of the fertilized egg outside the uterus (womb) such as: Tubalgravidity (tubal pregnancy), Ovariangravidity (pregnancy in the ovary), Peritonealgravidity/Abdominalgravidity (abdominal pregnancy), or Cervicalgravidity (a pregnancy in the cervix).

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Endometriosis – Occurrence of endometrium (lining of the uterus) outside the uterus, such as in or on the ovaries (ovaries), tubes (fallopian tubes), urinary bladder, or bowel. It is a chronic estrogen-dependent (female sex hormone) disease.
  • Renal colic, mainly caused by kidney stones.
  • Pyelonephritis (inflammation of the renal pelvis)