Differential Diagnosis of Abdominal Pain in a Younger Adult Male
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Differential Diagnosis of Abdominal Pain in a Younger Adult Male
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A 28-year-old man presents to an urgent care clinic with approximately 12 hours of abdominal pain accompanied by “feeling warm” with T to 100.4 degree F (38 d C) at home and mild nausea without vomit. He reports that the discomfort began with a feeling of “heartburn that did not get better with taking an antacid like it usually does”. During the past 6 hours, the pain has become more intense and has moved more to the lower right side of his abdomen, stating, “It’s hard to show you exactly where it hurts.” Walking makes the discomfort worse, and rest makes it somewhat better. He also reports little appetite and denies contact with individuals with similar symptom. He reports having two small soft stools earlier today. He denies dysuria, penile discharge, or scrotal pain.
Physical examination is unremarkable except for localized tenderness at McBurney's point with mild involuntary guarding. Genital exam WNL Vital signs: T 100.4°F (38°C), HR 96 beats/min, BP 122/76 mmHg.
This clinical presentation is most suggestive of:
A. Viral gastroenteritis
B. Acute appendicitis
C. Acute diverticulitis
D. Testicular torsion
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