All diseases leading to acute abdomen are differential diagnoses of pancreatitis. Only the most common differential diagnoses have been listed below for this purpose: Endocrine, nutritional, and metabolic diseases (E00-E90).
- Porphyria or acute intermittent porphyria (AIP); genetic disorder with autosomal dominant inheritance; patients with this disease have a 50% 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 – saccular dilation of the aorta.
- Pulmonary embolism – occlusion of pulmonary vessels.
- Mesenteric vein thrombosis – occlusion of veins supplying the intestine by a blood clot.
- Myocardial infarction (heart attack)
Infectious and parasitic diseases (A00-B99).
- Mumps (parotitis epidemica, salivitis epidemica; Goat Peter) – viral infection affecting the salivary gland and other organs.
Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).
- Cholelithiasis (gallstones).
- Cholecystitis (inflammation of the gallbladder)
- Gallbladder perforation – spontaneous opening of the gallbladder due to inflammation of the gallbladder.
- Biliary colic
Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93).
- Acute mesenteric ischemia (AMI; intestinal infarction, mesenteric artery occlusion, mesenteric infarction, mesenteric occlusive disease, angina abdominalis).
- Appendicitis (appendicitis).
- Intestinal perforation – spontaneous opening of the intestine usually due to a pre-existing intestinal disease such as diverticulitis.
- Ileus (intestinal obstruction)
- Gastric perforation – spontaneous opening of the stomach usually caused by a gastric ulcer (stomach ulcer).
- Ulcus duodeni (duodenal ulcer).
- Ulcus ventriculi (gastric ulcer)
Neoplasms – tumor diseases (C00-D48)
- Pancreatic carcinoma (pancreatic cancer) – most commonly diagnosed in the first year after acute pancreatitis (14.5 cases/1,000 patient-years); patients initially diagnosed as acute pancreatitis may have pancreatic cancer.
Psyche – Nervous System (F00-F99; G00-G99).
- Heroin dependence
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).
- Renal colic
Further
- Pseudoperitonitis – irritation of the peritoneum without an existing inflammation, occurring mainly in diabetes mellitus.
Medication
- See “Causes” under medications
Environmental pollution – intoxications (poisoning).
- Intoxications with insecticides such as E 605
