Intestinal Obstruction (Ileus): Or something else? Differential Diagnosis

Respiratory System (J00-J99)

  • Pneumonia (pneumonia)

Blood, blood-forming organs – immune system (D50-D90).

  • Hemolytic crisis – acute hemoptysis in the context of anemia (anemia).
  • Hemophilia (hemophilia).

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

  • Addisonian crisis – decompensation of insidious adrenocortical insufficiency.
  • Acute adrenal insufficiency
  • C1 esterase inhibitor deficiency (angioneurotic edema) – disease caused by the lack of an inhibitor of the complement system.
  • Diabetes mellitus (pseudoperitonitis diabetica).
  • Familial Mediterranean fever (FMF; synonym: familial recurrent polyserositis) – autosomal recessive inherited disease clustered in inhabitants of the eastern Mediterranean region; chronic disease characterized by sporadic episodes of fever with concomitant inflammation of the tunica serosa, resulting in abdominal pain (abdominal pain), thoracic pain or arthralgia (joint pain).
  • Hemochromatosis (iron storage disease) – genetic disease with autosomal recessive inheritance with increased deposition of iron as a result of increased iron concentration in the blood with tissue damage.
  • Hyperparathyroidism (parathyroid hyperfunction).
  • Cystic fibrosis (ZF) – genetic disease with autosomal recessive inheritance characterized by the production of secretions in various organs to be tamed. Meconium ileus – here: Meconium ileus (intestinal obstruction in newborns; usually the first sign of cystic fibrosis).
  • Food allergy
  • Food intolerance such as lactose intolerance, fructose intolerance.
  • Porphyria attack: 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).

Skin and subcutaneous (L00-L99).

  • Herpes zoster (shingles)

Cardiovascular system (I00-I99)

  • Aortic aneurysm – formation of a wall bulge in the aorta that can rupture (burst) (severe and sudden onset of pain)
  • Aortic dissection (synonym: aneurysm dissecans aortae) – acute splitting (dissection) of the wall layers of the aorta (aorta), with a tear of the inner layer of the vessel wall (intima) and a hemorrhage between the intima and the muscle layer of the vessel wall (outer media), in the sense of an aneurysm dissecans (pathological expansion of the aorta)
  • Heart failure (cardiac insufficiency).
  • Pulmonary embolism – pulmonary infarction occurring due to acute occlusion of pulmonary vessels.
  • Myocardial infarction (heart attack)
  • Ruptured abdominal aortic aneurysm (BAA)

Infectious and parasitic diseases (A00-B99).

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

  • Acute cholecystitis (inflammation of the gallbladder)
  • Acute pancreatitis (inflammation of the pancreas)
  • Alcohol hepatitis (inflammation of the liver)
  • Cholangitis (inflammation of the bile duct)
  • Biliary colic, usually triggered by gallstones (cholecystolithiasis).
  • Liver rupture (liver rupture)
  • Pancreatitis (inflammation of the pancreas)

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

  • Acute appendicitis (“appendicitis”).
  • Acute gastritis (inflammation of the gastric mucosa).
  • Acute mesenteric ischemia (AMI; intestinal infarction, mesenteric artery occlusion, mesenteric infarction, mesenteric occlusive disease, angina abdominalis; mesenteric vein thrombosis).
  • Abdominal wall hematomas, occur primarily during anticoagulant therapy
  • 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 – disease of the large intestine, in which inflammation is formed in protrusions of the mucosa (diverticula).
  • Gastroparesis – loss of tone of the stomach muscles.
  • Infectious colitis – inflammation of the intestine caused by bacteria, viruses or parasites such as salmonella.
  • Incarcerated hernia – incarcerated soft tissue hernia (inguinal, umbilical, incisional).
  • 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 small intestine, which is a developmental remnant.
  • 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 may 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 actinomycete group), 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.
  • Meteorism (flatulence)
  • 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.
  • Lymphadenitis mesenterialis – bacterial infection that leads to right-sided abdominal pain; affects the abdominal lymph nodes.
  • Ogilvie syndrome (acute pseudoobstruction of the colon): dilatation of the colon (mostly cecal pole and ascending colon) without evidence of mechanical stenosis; occur almost exclusively in hospitalized, critically ill patients with previous surgery, severe infections, as well as neurological diseases (Parkinson’s disease); conservative therapy as far as no signs of sepsis and perforation or ischemia are excluded.
  • Esophageal spasm – spasmodic constriction of the esophagus.
  • Perforation of hollow organs in the abdomen such as the stomach or intestine perforation (violent and sudden onset of pain).
  • Peritonitis (inflammation of the peritoneum).
  • Rectal ulcer (rectal ulcer)
  • Irritable bowel syndrome (colon irritable)
  • Sigmoid diverticulitis – inflammation around an infected diverticulum (protrusion of the intestinal wall).
  • Typhlitis – inflammation of the appendix (appendix) and ascending colon (colon), and sometimes the terminal ileum (end section of the scrotum or hip).
  • Radiation colitis – disease that can occur after radiation, especially in the context of cancer therapy.
  • Toxic megacolon – toxin-induced paralysis and massive dilatation of the colon (widening of the large intestine; > 6 cm), which is accompanied by acute abdomen (most severe abdominal pain), vomiting, clinical signs of shock, and sepsis (blood poisoning); complication of ulcerative colitis; lethality (mortality related to the total number of people suffering from the disease) is approximately 30%.
  • Volvulus – rotation of a section of the digestive tract around its mesenteric axis; possible complications include mechanical ileus or intestinal gangrene (death of a section of the intestine due to insufficient oxygen supply)

Musculoskeletal system and connective tissue (M00-M99).

  • Dermatomyositis – rare collagenosis that often occurs paraneoplastic.
  • 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 corpus ciliary (corpus ciliare) and the iris), is stated as typical for the disease; a defect in cellular immunity is suspected
  • Lupus erythematosus disseminatus – autoimmune disease that leads to various changes in the skin, joints and internal organs.
  • Nucleus pulposus prolapse (herniated disc).
  • Panarteriits nodosa – collagenosis leading to thickening of the vessel walls and thus to deficiency of blood flow.

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).
  • Leukemia (blood cancer)
  • Lymphoma – malignant disease originating in the lymphatic system.
  • Colon carcinoma (colon cancer)
  • Gastric carcinoma
  • Pancreatic carcinoma (cancer of the pancreas)
  • Tumors of any kind in the abdominal region.

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

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).

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Ischuria (urinary retention).
  • Uremia (occurrence of urinary substances in the blood above normal values).

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

  • Adnexitis – inflammation of the fallopian tubes and ovary.
  • Endometriosis – occurrence of endometrium outside the endometrial layer of the uterus.
  • Testicular torsion (testicular torsion).
  • Mid-cycle pain (intermenstrual pain) – lower abdominal pain occurring in the middle of a woman’s menstrual cycle, probably due to the follicular rupture
  • Renal infarction
  • Renal colic, mainly caused by kidney stones
  • Ovarian cyst, pedunculated – water-filled tumor in the region of the ovary, whose supplying vessels have been pinched off.
  • Perforation of the urinary bladder (severe and sudden onset of pain).
  • Pyelonephritis (inflammation of the renal pelvis)
  • Urolithiasis (urinary stone disease)
  • Cystitis (inflammation of the bladder)

Injuries, poisonings, and other consequences of external causes (S00-T98).

Medication

  • Quinine intoxication (antimalarial drug).
  • Drug withdrawal

Environmental pollution – intoxications (poisonings).

  • Arsenic intoxication (arsenic)
  • Lead intoxication (lead)
  • Intoxications (poisoning) – by various toxins (spiders, snakes, insects).
  • Thallium intoxication