Differential Diagnosis for Left Lower Quadrant Pain in Men
Single Most Likely Diagnosis
- Diverticulitis: This is the most common cause of left lower quadrant pain in men, especially those over 40 years old. Diverticulitis occurs when diverticula in the colon become inflamed, leading to pain, tenderness, and potentially serious complications.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): A common condition characterized by abdominal pain, bloating, and changes in bowel habits. While IBS can cause pain in any quadrant, it often affects the lower quadrants.
- Constipation: Severe constipation can cause significant abdominal pain, including in the left lower quadrant, due to the accumulation of stool and gas.
- Inguinal Hernia: An inguinal hernia can cause pain in the left lower quadrant, especially if the hernia is large or incarcerated.
- Kidney Stone: A kidney stone can cause severe pain that radiates to the left lower quadrant if the stone is located in the left ureter.
Do Not Miss Diagnoses
- Appendicitis (with atypical presentation): Although appendicitis typically presents with right lower quadrant pain, it can occasionally present with left lower quadrant pain, especially if the appendix is retrocecal or has a long mesentery.
- Ectopic Pregnancy (in a male with a female partner): While ectopic pregnancy is not a direct cause of pain in men, it's essential to consider the possibility if the patient's partner is experiencing symptoms.
- Testicular Torsion: Testicular torsion can cause severe pain that radiates to the lower abdomen, including the left lower quadrant.
- Abdominal Aortic Aneurysm: A ruptured abdominal aortic aneurysm can cause severe abdominal pain, including in the left lower quadrant, and is a medical emergency.
Rare Diagnoses
- Colonic Cancer: Colonic cancer can cause left lower quadrant pain, especially if the tumor is located in the sigmoid colon.
- Inflammatory Bowel Disease (e.g., Crohn's disease, Ulcerative Colitis): These conditions can cause chronic abdominal pain, including in the left lower quadrant, due to inflammation and ulceration of the bowel.
- Ovarian Torsion (in a male with a female partner): Similar to testicular torsion, ovarian torsion can cause severe pain that radiates to the lower abdomen.
- Splenic Infarction or Rupture: Splenic infarction or rupture can cause severe left upper quadrant pain that radiates to the left lower quadrant.