What is the differential diagnosis (DDX) of left lower quadrant (LLQ) abdominal pain?

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Differential Diagnosis for Left Lower Quadrant Abdominal Pain

The differential diagnosis for left lower quadrant abdominal pain can be organized into the following categories:

  • Single Most Likely Diagnosis
    • Diverticulitis: This is the most common cause of left lower quadrant abdominal pain, especially in older adults. It is characterized by inflammation of the diverticula in the colon, which can cause severe pain, tenderness, and changes in bowel habits.
  • Other Likely Diagnoses
    • Constipation: Constipation is a common cause of abdominal pain, including in the left lower quadrant. It can be caused by a variety of factors, including diet, lifestyle, and underlying medical conditions.
    • Irritable Bowel Syndrome (IBS): IBS is a chronic condition characterized by abdominal pain, bloating, and changes in bowel habits. It can cause pain in any quadrant of the abdomen, including the left lower quadrant.
    • Inflammatory Bowel Disease (IBD): IBD, including conditions such as Crohn's disease and ulcerative colitis, can cause abdominal pain, diarrhea, and weight loss. The pain can be localized to the left lower quadrant.
    • Ovarian Cyst or Torsion: In women, ovarian cysts or torsion can cause severe left lower quadrant abdominal pain, often accompanied by nausea, vomiting, and fever.
  • Do Not Miss Diagnoses
    • Ectopic Pregnancy: An ectopic pregnancy, where the embryo implants outside the uterus, can cause severe abdominal pain, including in the left lower quadrant. This is a life-threatening condition that requires immediate medical attention.
    • Ruptured Abdominal Aortic Aneurysm: A ruptured abdominal aortic aneurysm can cause severe abdominal pain, including in the left lower quadrant, and is a medical emergency.
    • Bowel Obstruction: A bowel obstruction can cause severe abdominal pain, including in the left lower quadrant, and can lead to serious complications if not treated promptly.
    • Sigmoid Volvulus: A sigmoid volvulus, where the sigmoid colon twists on itself, can cause severe abdominal pain, including in the left lower quadrant, and requires prompt medical attention.
  • Rare Diagnoses
    • Intussusception: Intussusception is a rare condition where a part of the intestine telescopes into another part, causing abdominal pain, including in the left lower quadrant.
    • Mesenteric Ischemia: Mesenteric ischemia, where the blood flow to the intestine is compromised, can cause severe abdominal pain, including in the left lower quadrant, and requires prompt medical attention.
    • Left Lower Quadrant Hernia: A hernia in the left lower quadrant can cause abdominal pain and requires surgical evaluation.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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