Diverticular Disease: Or something else? Differential Diagnosis

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

  • Diabetes mellitus
  • Food intolerance such as lactose 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 in the foreground, causing abdominal colic (acute abdomen), nausea (nausea), vomiting or constipation (constipation), as well as tachycardia (heartbeat too fast: > 100 beats per minute) 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.
  • Lymphadenitis mesenterialis – bacterial infection leading to right-sided abdominal pain; affects abdominal lymph nodes.
  • 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 appendicitis (“appendicitis).
  • Acute mesenteric ischemia (AMI; intestinal infarction, mesenteric artery occlusion, mesenteric infarction, mesenteric occlusive disease, angina abdominalis)[incidence: 1%; in those over 70 years of age: up to 10%]
  • Colitis indeterminata – disease that is a combination of ulcerative colitis and Crohn’s disease.
  • Diversion colitis – disease occurring after surgical immobilization of intestinal segments.
  • Ileus (intestinal obstruction)
  • Infectious colitis – inflammation of the intestine caused by bacteria, viruses or parasites such as salmonella.
  • 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.
  • 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 disease – chronic inflammatory bowel disease (IBD); 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 can be affected several intestinal sections, which are separated from each other by healthy sections.
  • Whipple’s disease – rare systemic infectious disease; caused by the gram-positive rod bacterium Tropheryma whippelii (from the group of actinomycetes), which can affect various other organ systems in addition to the obligately affected intestinal system and is a chronic recurrent disease; symptoms: Fever, arthralgia (joint pain), brain dysfunction, weight loss, diarrhea (diarrhea), abdominal pain (abdominal pain), and more.
  • Food allergy
  • Peritonitis (inflammation of the peritoneum)
  • Pseudomembranous colitis (synonym: antibiotic-associated colitis) – occurs when the intestinal flora (usually iatrogenically caused) is damaged by antibiotics to such an extent that the bacterium Clostridium difficile can multiply strongly as a result.
  • Rectal ulcer (rectal ulcer)
  • Irritable bowel syndrome (colon irritable)
  • Segmental colitis (SCAD)
  • Sigmoiditis – clinical picture associated with diverticular disease in which the inflammatory changes are not limited to the peridiverticular areas but affect the entire diverticular-bearing intestinal segment
  • Radiation colitis – disease that can occur after radiation, especially in the context of cancer therapy.

Musculoskeletal system and connective tissue (M00-M99).

  • Coxarthrosis (osteoarthritis of the hip joint)
  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease from the rheumatic form circle, which is 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
  • Sacroiliitis – inflammation of the sacroiliac joint between the sacrum and the ilium.

Neoplasms – tumor diseases (C00-D48).

  • 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).
  • Colon carcinoma (colon cancer; most important differential diagnosis in old age).
  • Lymphoma – malignant disease originating in the lymphatic system.
  • Pancreatic carcinoma (cancer of the pancreas).

Psyche – nervous system (F00-F99; G00-G99)

  • Nucleus propulsus prolapse (herniated disc).

Pregnancy, childbirth, and puerperium (O00-O99).

  • Extrauterine pregnancy – pregnancy outside the uterus; extrauterine pregnancy is present in approximately 1% to 2% of all pregnancies: Tubalgravidity (ectopic pregnancy), Ovariangravidity (pregnancy in the ovary), Peritonealgravidity or Abdominalgravidity (pregnancy in the abdominal cavity), Cervicalgravidity (pregnancy in the cervix).

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