Abdominal symptoms may be a presenting finding for a patient with lead poisoning. If the possibility of lead poisoning is not considered based on occupational, recreational or herbal medicine history, then unnecessary and expensive studies may be performed.
Lead poisoning may present with:
(1) abdominal pain, typically recurrent and colicky
(2) intestinal obstruction
(3) chronic constipation
Misdiagnoses may include:
(1) irritable bowel syndrome
(2) psychiatric disorder
(3) porphyria
(4) chronic cholecystitis
(5) chronic pancreatitis
The diagnosis is usually not a problem if:
(1) a complete occupational, environmental and hobby history is taken
(2) a complete description of alternative medical and herbal supplements is collected
(3) a complete family and social history (especially for a history of lead poisoning)
(4) serum lead testing is performed
The diagnosis can be a problem if:
(1) the patient has a history of intra-abdominal surgery or cancer
(2) the patient has other reasons for abdominal complaints
(3) the patient has gallstones
