Differential Diagnosis for LLQ Pain
- Single most likely diagnosis
- Diverticulitis: This is a common cause of left lower quadrant (LLQ) pain, especially in older adults. The pain is usually constant and accompanied by changes in bowel habits, fever, and nausea.
- Other Likely diagnoses
- Constipation: Severe constipation can cause LLQ pain due to the accumulation of feces in the sigmoid colon.
- Irritable Bowel Syndrome (IBS): IBS can cause recurrent abdominal pain, including LLQ pain, often accompanied by changes in bowel habits.
- Ovarian cyst or torsion: In females, ovarian cysts or torsion can cause LLQ pain, which may be severe and sudden in onset.
- Kidney stone: A kidney stone in the left ureter can cause severe LLQ pain, often radiating to the groin.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ruptured abdominal aortic aneurysm: Although less common, a ruptured abdominal aortic aneurysm can cause LLQ pain and is a medical emergency.
- Ectopic pregnancy: In females of childbearing age, an ectopic pregnancy can cause LLQ pain and is a life-threatening condition if not promptly diagnosed.
- Intestinal obstruction: An intestinal obstruction can cause severe LLQ pain, vomiting, and constipation, and requires prompt surgical intervention.
- Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): These conditions can cause chronic LLQ pain, diarrhea, and weight loss.
- Rare diagnoses
- Colonic cancer: Although less common, colonic cancer can cause LLQ pain, especially in older adults with a history of colon polyps or family history of colon cancer.
- Endometriosis: In females, endometriosis can cause chronic LLQ pain, especially during menstruation.
- Ureteropelvic junction obstruction: This rare condition can cause LLQ pain due to obstruction of the ureter.
- Retroperitoneal fibrosis: This rare condition can cause LLQ pain due to inflammation and scarring of the tissues behind the peritoneum.