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A 27-year-old man presents with crampy abdominal pain of sudden onset

27 years old | Male

Vignette:

A 27-year-old man presents with crampy abdominal pain of sudden onset, emesis, and failure to pass any gas or stool for 24 hours. The patient has no history of prior surgery. Physical exam reveals peritonitis, and abdominal x-rays demonstrate air-fluid levels.

Summary:

crampy abdominal pain | sudden onset | emesis | failure to pass gas | failure to pass stool | 24 hours | peritonitis | radiograph air-fluid levels

Dx:

Intestinal Obstruction Small bowel obstruction

Ref:

https://online.epocrates.com/diseases/99322/Small-bowel-obstruction/Common-Vignette

Rank

Disease

Weight

1 Intestinal Obstruction 370.0
2 Emphysematous cholecystitis 253.0
3 Acute Cholecystitis 253.0
4 Acute Appendicitis 222.0
5 Acute perforated appendicitis 222.0
6 Intussusception 220.0
7 Acute Pancreatitis 218.0
8 Anaphylaxis 214.0
9 Hereditary Angioedema 210.0
10 Ileus 203.0
11 Aortic Dissection 200.0
12 Spontaneous bacterial peritonitis 197.0
13 Non-cholera Vibrio infections 197.0
14 Sigmoid volvulus 196.0
15 Mesenteric ischemia 192.0
16 Diverticulitis 191.0
17 Amebic Liver Abscess 189.0
18 Ovarian and fallopian tube torsion 184.0
19 Acute peptic ulcer 176.0
20 Diabetic Ketoacidosis 176.0
21 Adrenal crisis 174.0
22 Acute intermittent porphyria 170.0
23 Gallstone pancreatitis 169.0
24 pancreatic cancer 166.0
25 Gallbladder cancer 164.0
26 Peritoneal dialysis associated peritonitis 164.0
27 chronic acalculous cholecystitis 164.0
28 Acalculous Cholecystitis 163.0
29 Tuberculous Peritonitis 163.0
30 Addison Disease 163.0
31 Intestinal malrotation 159.0
32 Pyogenic Liver Abscess 159.0
33 Acute fatty liver of pregnancy 159.0
34 Kidney stones 159.0
35 Foreign body ingestion 157.0
36 mucosal Eosinophilic gastroenteritis 156.0
37 Shigellosis 154.0
38 Gastroparesis 153.0
39 Esophagitis 153.0
40 Meckel diverticulum 152.0
41 Gastric Outlet Obstruction 150.0
42 Biliary cirrhosis 146.0
43 Primary sclerosing cholangitis 146.0
44 Primary biliary cirrhosis 146.0
45 Anthrax 144.0
46 Alcoholic Fatty Liver 140.0
47 biliary colic 140.0
48 Endometriosis 139.0
49 Campylobacter infection 139.0
50 Rocky Mountain spotted fever 138.0
51 Crohn Disease 137.0
52 Hepatorenal Syndrome 135.0
53 Bacterial pharyngitis 135.0
54 Toxic Megacolon 132.0
55 Autosomal Dominant Polycystic Kidney Disease 132.0
56 Viral Gastroenteritis 131.0
57 Hemolytic uremic syndrome 131.0
58 Non-ST-elevation myocardial infarction 130.0
59 Ulcerative Colitis 129.0
60 Splenic Infarction 127.0
61 Gastritis 126.0
62 Alcoholic Liver Disease 126.0
63 Klebsiella pneumoniae liver abscess 126.0
64 Ruptured ovarian cyst 126.0
65 Acute pericarditis 125.0
66 Food poisoning 124.0
67 Muscle Layer Eosinophilic gastroenteritis 123.0
68 Intestinal Pseudo Obstruction 123.0
69 Angle Closure Glaucoma 123.0
70 Acute Cholangitis 122.0
71 Liver Cirrhosis 121.0
72 Labyrinthitis 121.0
73 Travelers diarrhea 120.0
74 Giardiasis 120.0
75 Sarcoidosis 120.0
76 Acetaminophen overdose 118.0
77 Migraine headache in adults 117.0
78 Cholera 115.0
79 Bell palsy 114.0
80 Intra-abdominal abscess 113.0
81 Ruptured ectopic pregnancy 112.0
82 Typhoid infection 112.0
83 biliary SOD 112.0
84 Colorectal cancer 111.0
85 Gastric Volvulus 111.0
86 Acute pelvic inflammatory disease 111.0
87 Lactose intolerance 110.0
88 Ovarian Torsion 110.0
89 Chronic heart failure 109.0
90 Systemic sclerosis 109.0
91 Thrombotic thrombocytopenic purpura 108.0
92 Stroke 108.0
93 subserosal eosinophilic gastroenteritis 107.0
94 Intraperitoneal bleeding 106.0
95 Non-small cell lung cancer 106.0
96 Foodborne E coli infection 105.0
97 Cataract 105.0
98 Kawasaki disease 104.0
99 Alcoholic hepatitis 103.0
100 Alcoholic Liver Cirrhosis 103.0
101 Ischemic stroke 103.0
102 Gallbladder Dyskinesia 103.0
103 Stable ischemic heart disease 103.0
104 Analgesic nephropathy 102.0
105 Churg-Strauss Syndrome 102.0
106 Irritable Bowel Syndrome 101.0
107 Ovarian Cancer 101.0
108 Choledocholithiasis 101.0
109 Chronic Kidney Diseases 101.0
110 Acute Clonorchiasis 100.0
111 Intestinal Entamoeba histolytica amebiasis 100.0
112 Common cold(adults) 100.0
113 Listerial gastroenteritis 99.0
114 Type 2 Diabetes mellitus 99.0
115 Diabetic Neuropathy 99.0
116 Salmonella infection 97.0
117 Epiploic appendagitis 97.0
118 Chronic bacterial prostatitis 97.0
119 Polyarteritis nodosa 96.0
120 Hyperosmolar Hyperglycemic state 96.0
121 Duodenal Ulcer 95.0
122 Gastric Ulcer 95.0
123 Liver disease 94.0
124 Acute otitis media 94.0
125 Acute viral meningitis 93.0
126 Choledochal Cyst 92.0
127 Central retinal artery occlusion 92.0
128 Eosinophilic gastroenteritis 91.0
129 Henoch-Schonlein purpura 91.0
130 Hemorrhagic stroke 91.0
131 Amphetamine use disorder 90.0
132 Acute bacterial meningitis in children 90.0
133 Alopecia areata 90.0
134 Cystic Fibrosis 89.0
135 Sphincter of Oddi Dysfunction 89.0
136 pancreatic SOD 89.0
137 Dyspepsia 88.0
138 Gallstones 88.0
139 Malaria 88.0
140 Peptic Ulcer 87.0
141 ST-elevation myocardial infarction 87.0
142 Hypertriglyceridemia 86.0
143 Panic disorder in adults 84.0
144 COPD Exacerbation 84.0
145 Gastroenteritis 83.0
146 Biliary cyst 83.0
147 Hypercalcemia 82.0
148 Common cutaneous drug reactions 82.0
149 Brucellosis 82.0
150 Acute Hepatitis 82.0
151 Carpal Tunnel Syndrome 82.0
152 Motion Sickness 82.0
153 Gastrointestinal Hemorrhage 81.0
154 Lower gastrointestinal hemorrhage 81.0
155 Upper gastrointestinal hemorrhage 81.0
156 Pancreatic Pseudocyst 81.0
157 Chronic Hepatitis 81.0
158 Eclampsia 81.0
159 Bacterial gastroenteritis 80.0
160 Transient ischemic attack 80.0
161 Cellulitis 79.0
162 Candidal intertrigo 79.0
163 Wilson disease 77.0
164 Ascites 76.0
165 Acute peritonitis 75.0
166 Adrenal Suppression 75.0
167 Acute bacterial meningitis in neonates 74.0
168 Leiomyomas 73.0
169 Acute Liver Failure 73.0
170 Cholangiocarcinoma 73.0
171 Gout 73.0
172 End Stage Renal Disease 73.0
173 Chronic pyelonephritis 73.0
174 Insect bites and stings 72.0
175 Gastric cancer 71.0
176 Primary Myelofibrosis 71.0
177 Autosomal Recessive Polycystic Kidney Disease 71.0
178 Aseptic meningitis 71.0
179 Hepatocellular carcinoma 70.0
180 Ankylosing spondylitis 69.0
181 Clostridium difficile infection 69.0
182 Inguinal hernia 68.0
183 Adrenocortical carcinoma 68.0
184 Cushing syndrome 68.0
185 Pyelonephritis 68.0
186 Ovarian Hyperstimulation Syndrome 67.0
187 Budd Chiari Syndrome 66.0
188 Graves Disease 66.0
189 Torsion of appendix of testis 65.0
190 Diabetes Mellitus 64.0
191 Heparin-induced thrombocytopenia 64.0
192 Ruptured Tuboovarian abscess 64.0
193 Preeclampsia 64.0
194 Inflammatory Bowel Diseases 63.0
195 Hiatus hernia 63.0
196 Annular pancreas 62.0
197 Pneumonia 62.0
198 Psoas Abscess 62.0
199 Chronic fatigue syndrome 61.0
200 Chronic Renal vein thrombosis 61.0
201 Urinary Tract Obstruction 61.0
202 Fibromyalgia 60.0
203 Hepatic Encephalopathy 60.0
204 Diabetic Kidney Disease 60.0
205 Mallory-Weiss syndrome 60.0
206 Zollinger-Ellison Syndrome 59.0
207 Rheumatoid Arthritis 59.0
208 Granulomatosis with polyangiitis 59.0
209 Pheochromocytoma 58.0
210 Lung Cancer 58.0
211 Familial Mediterranean fever 57.0
212 Subdural hematoma 57.0
213 Chronic Pancreatitis 56.0
214 Vulvovaginal candidiasis 56.0
215 Autoimmune hepatitis 55.0
216 Obstructive Sleep Apnea 55.0
217 Acute disseminated encephalomyelitis 55.0
218 Atopic dermatitis 55.0
219 Systemic vasculitis 54.0
220 Acromegaly 54.0
221 Acute Lymphoblastic leukemia in children 54.0
222 Multiple Sclerosis 54.0
223 Migraine 54.0
224 Parkinson disease 54.0
225 Systemic lupus erythematosus 53.0
226 anterior ischemic optic neuropathy 53.0
227 Croup 53.0
228 Musculoskeletal sprains and strains 53.0
229 Infectious mononucleosis 51.0
230 Umbilical hernia 51.0
231 Fungal meningitis 51.0
232 Papilledema 51.0
233 Glomerulonephritis 50.0
234 Exocrine pancreatic insufficiency 50.0
235 Breast Cancer 50.0
236 Anemia of chronic disease 50.0
237 Varicocele 50.0
238 Acute bacterial meningitis in adults 50.0
239 Milk-alkali syndrome 50.0
240 Chronic meningitis 50.0
241 Chronic Milk-alkali syndrome 50.0
242 Acute Milk-alkali syndrome 50.0
243 Infertility in women 50.0
244 Pulmonary Embolism 49.0
245 Hyperparathyroidism 48.0
246 Multiple endocrine neoplasia 2B 48.0
247 Premature labor 48.0
248 Charcot-Marie-Tooth Disease 48.0
249 Unstable angina 48.0
250 Multiple endocrine neoplasia 2A 47.0
251 Chronic atrial fibrillation 47.0
252 posteriorischemic optic neuropathy 47.0
253 Autoimmune Pancreatitis 45.0
254 Aortic coarctation 45.0
255 Amyloidosis 45.0
256 Meniere disease 45.0
257 Celiac Disease 44.0
258 Hereditary hemochromatosis 44.0
259 Abdominal compartment syndrome 44.0
260 Familial adenomatous polyposis syndrome 44.0
261 Type 1 Diabetes mellitus 42.0
262 Hyperthyroidism 41.0
263 Chronic pelvic pain in women 41.0
264 Empyema 41.0
265 Stevens-Johnson syndrome 41.0
266 Secondary Peritonitis 41.0
267 Bladder Cancer 40.0
268 Blepharitis 40.0
269 COVID19 39.0
270 Chronic Cholecystitis 39.0
271 Allergic rhinitis 39.0
272 Achilles tendinopathy 39.0
273 Achilles tendon rupture 39.0
274 Acute bacterial rhinosinusitis 39.0
275 Rumination Syndrome 38.0
276 Hyperprolactinemia 38.0
277 Guillain-Barre syndrome 38.0
278 Chronic Lymphocytic Leukemia 37.0
279 Pelvic inflammatory disease 36.0
280 Endometrial cancer 36.0
281 Malt lymphoma 36.0
282 Diabetic Amyotrophy 36.0
283 Short bowel syndrome 35.0
284 Acute Myeloid Leukemia in children 35.0
285 Non-diabetic hypoglycemia 35.0
286 Endometritis 34.0
287 Sunburn 34.0
288 Oral candidiasis 34.0
289 Oropharyngeal and esophageal candidiasis 34.0
290 Candida Balanitis 34.0
291 Peutz-Jeghers Syndrome 32.0
292 Gastroesophageal reflux disease 32.0
293 Herpes zoster 32.0
294 Splenic abscess 32.0
295 Limited cutaneous systemic sclerosis 32.0
296 Stable angina 32.0
297 Hypogammaglobulinemia 32.0
298 Acute Myeloid Leukemia in adults 31.0
299 Liver Abscess 31.0
300 Cryptococcosis 31.0
301 Insomnia in adults 31.0
302 Disseminated intravascular coagulation 29.0
303 Renal Cell Carcinoma 29.0
304 Influenza 29.0
305 Hypoparathyroidism 29.0
306 Acute cervical spine trauma 29.0
307 Acute respiratory failure 29.0
308 Dry eye 29.0
309 Hypothyroidism 28.0
310 Chronic Myeloid Leukemia 28.0
311 Gilbert syndrome 27.0
312 Varicose veins 27.0
313 Osteoarthritis 27.0
314 Acute Rhinosinusitis 27.0
315 Acute viral rhinosinusitis 27.0
316 Anaplastic thyroid cancer 26.0
317 Prinzmetal angina 26.0
318 Hyperaldosteronism 26.0
319 Simple kidney cyst 26.0
320 Tetanus 26.0
321 Chronic Clonorchiasis 25.0
322 Dubin-Johnson syndrome 25.0
323 Multiple Myeloma 25.0
324 Prolactinoma 25.0
325 Abnormal uterine bleeding 25.0
326 Renal and perinephric abscess 24.0
327 Periorbital and orbital cellulitis 24.0
328 Prostatitis 24.0
329 Chronic prostatitis 24.0
330 Acute Bacterial Prostatitis 24.0
331 Globus Sensation 24.0
332 Non-alcoholic Fatty Liver Disease 23.0
333 Portal hypertension 23.0
334 Chronic Mitral regurgitation 23.0
335 Von willebrand disease 22.0
336 Common cold(children) 22.0
337 Animal bites 22.0
338 Rosacea 22.0
339 Peritonitis 22.0
340 Cholecystitis 21.0
341 Amebiasis 21.0
342 Chlamydia pneumoniae infection 21.0
343 Tuboovarian abscess 20.0
344 Mirizzi Syndrome 20.0
345 Alzheimer disease 20.0
346 Zenker diverticulum 20.0
347 Pancreatitis 20.0
348 Acne fulminans 20.0
349 Priapism 20.0
350 Tinnitus 20.0
351 Oropharyngeal cancer 20.0
352 Atypical pneumonia 20.0
353 Parkinsonism 20.0
354 Candidiasis 20.0
355 Erectile dysfunction 20.0
356 Keloid 19.0
357 Achalasia 18.0
358 Uveitis 18.0
359 Anterior uveitis 18.0
360 Intermediate uveitis 18.0
361 Posterior uveitis 18.0
362 Pan uveitis 18.0
363 Peroneal Neuropathy 18.0
364 Osteoporosis 18.0
365 Bed bugs 17.0
366 Open Angle Glaucoma 17.0
367 Renal Artery Stenosis 17.0
368 Peyronie Disease 17.0
369 Ischemic optic neuropathy 17.0
370 Androgenetic alopecia 17.0
371 Extraintestinal Entamoeba histolytica amebiasis 16.0
372 Recurrent aphthous stomatitis 16.0
373 Osteomyelitis 16.0
374 Gestational diabetes mellitus 16.0
375 Menopause 16.0
376 Secondary hyperparathyroidism 16.0
377 Testicular cancer 15.0
378 Acute Lymphocytic Leukemia in Adults 15.0
379 Clonorchiasis 14.0
380 Psychogenic polydipsia 14.0
381 Intrahepatic cholestasis of pregnancy 14.0
382 Chronic liver disease 14.0
383 Mitral Stenosis 14.0
384 Enterovesical fistula 14.0
385 Extrahepatic Cholestasis 13.0
386 Intrahepatic Cholestasis 13.0
387 Abetalipoproteinemia 13.0
388 Aortic stenosis 13.0
389 Tinea versicolor 13.0
390 Toxic thyroid adenoma 12.0
391 Acute Cystitis(Women) 12.0
392 Optic neuritis 11.0
393 Neuropapillitis 11.0
394 Critical Illness Polyneuropathy 11.0
395 Nephrogenic diabetes insipidus 11.0
396 Central diabetes insipidus 11.0
397 Acute Cystitis(Men) 11.0
398 Cystitis 11.0
399 Splenic Rupture 11.0
400 Vaginitis 11.0
401 Urethritis 11.0
402 Phimosis 11.0
403 Paraphimosis 11.0
404 Ectopic Pregnancy 10.0
405 Acute heart failure 10.0
406 Morton neuroma 10.0
407 Pressure ulcer 9.0
408 Acute atrial fibrillation 9.0
409 Scleritis 8.0
410 Anterior scleritis 8.0
411 Posterior scleritis 8.0
412 Bullous pemphigoid 8.0
413 Goiter 8.0
414 Diffuse nontoxic goiter 8.0
415 Toxic multinodular goiter 8.0
416 Obstructive cervical goiters 8.0
417 Cervical goiter 8.0
418 Asthma 8.0
419 Paraneoplastic Syndromes 8.0
420 Drowning 8.0
421 Primary ciliary dyskinesia 7.0
422 Kartagener syndrome 7.0
423 Pseudohypoparathyroidism 7.0
424 Cryptorchidism 7.0
425 Renal vein thrombosis 7.0
426 Acute Renal vein thrombosis 7.0
427 Immune thrombocytopenia 6.0
428 Painless thyroiditis 6.0
429 Angiodysplasia of the colon 6.0
430 Acute Bronchitis 5.0
431 Osteomalacia 5.0
432 Dacryocystitis 5.0
433 Epididymo-orchitis 3.0
434 Medullary thyroid cancer 2.0
435 Thyroid lymphoma 2.0
436 Hemorrhoids 0.0
437 Acute pyelonephritis in adults 0.0
438 Discogenic low back pain 0.0
439 Essential Tremor 0.0
440 Trachoma 0.0
441 Myasthenia Gravis 0.0
442 Neonatal Myasthenia Gravis 0.0
443 Congenital Myasthenic Syndromes 0.0
444 Acute epididymitis 0.0
445 Musculoskeletal lower back pain 0.0
446 Bruxism 0.0
447 Mucormycosis 0.0
448 Myoclonus 0.0