Differential Diagnosis for Severe Pelvic Pain (Left Sided)
Single Most Likely Diagnosis
- Ovarian Cyst or Torsion: This is a common cause of severe, unilateral pelvic pain in women, especially if there's a history of similar episodes or known ovarian cysts. The pain can be sudden and severe, often accompanied by nausea and vomiting.
Other Likely Diagnoses
- Ectopic Pregnancy: Although less common, ectopic pregnancy is a significant cause of severe pelvic pain, especially if the patient is of childbearing age and has a history of infertility, previous ectopic pregnancy, or pelvic surgery.
- Pelvic Inflammatory Disease (PID): PID can cause severe pelvic pain, especially if it involves the left fallopian tube or ovary. The pain is often accompanied by fever, vaginal discharge, and other symptoms of infection.
- Diverticulitis: Inflammation of the diverticula in the sigmoid colon can cause severe left-sided pelvic pain, especially if the diverticula rupture or become abscessed.
- Kidney Stone: A kidney stone passing down the left ureter can cause severe, colicky pain that radiates to the left pelvis.
Do Not Miss Diagnoses
- Ruptured Aortic Aneurysm: Although rare, a ruptured abdominal aortic aneurysm can cause severe pelvic pain, especially if it involves the left common iliac artery. This is a life-threatening condition that requires immediate attention.
- Appendicitis (Atypical Presentation): Appendicitis can occasionally present with left-sided pelvic pain, especially if the appendix is retrocecal or retroperitoneal.
- Ovarian Cancer: Although less common, ovarian cancer can cause severe pelvic pain, especially if it involves the left ovary or fallopian tube.
Rare Diagnoses
- Endometriosis: Endometriosis can cause chronic pelvic pain, but it's less likely to cause severe, acute pain unless there's a complication such as an endometrioma rupture.
- Ureteral Injury: A ureteral injury or obstruction can cause severe pelvic pain, especially if it involves the left ureter.
- Pelvic Fracture: A pelvic fracture can cause severe pelvic pain, especially if it involves the left pelvis or sacrum.