Differential Diagnosis for Right Iliac Fossa (RIF) Pain: Torsion vs Cyst
Single Most Likely Diagnosis
- Ovarian torsion: This is a highly likely diagnosis due to the sudden onset of severe RIF pain, which is a classic symptom of ovarian torsion. The pain is often accompanied by nausea, vomiting, and abdominal tenderness.
- Ovarian cyst: A ruptured or hemorrhagic ovarian cyst can also cause severe RIF pain, making it a likely diagnosis. The pain may be accompanied by vaginal bleeding, fever, and abdominal tenderness.
Other Likely Diagnoses
- Appendicitis: Although the pain of appendicitis typically starts near the umbilicus and then moves to the right lower quadrant, it can sometimes present with RIF pain, making it a possible diagnosis.
- Ectopic pregnancy: A ruptured ectopic pregnancy can cause severe RIF pain, especially if the pregnancy is located in the right fallopian tube.
- Diverticulitis: Inflammation of the diverticula in the sigmoid colon can cause RIF pain, especially if the diverticula are located in the right colon.
Do Not Miss Diagnoses
- Ectopic pregnancy with rupture: This is a life-threatening condition that requires immediate attention. Missing this diagnosis can lead to severe bleeding, shock, and even death.
- Ovarian torsion with necrosis: If ovarian torsion is not treated promptly, the ovary can become necrotic, leading to infertility and other complications.
- Appendiceal rupture: A ruptured appendix can lead to peritonitis, sepsis, and death if not treated promptly.
Rare Diagnoses
- Mesenteric lymphadenitis: Inflammation of the lymph nodes in the mesentery can cause RIF pain, although this is a rare condition.
- Right ureteral stone: A stone in the right ureter can cause severe RIF pain, although this is less common than other causes of RIF pain.
- Retroperitoneal hemorrhage: Bleeding in the retroperitoneal space can cause RIF pain, although this is a rare condition often associated with trauma or anticoagulation.