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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: June 4, 2025 • View editorial policy

Differential Diagnosis for Right Lower Quadrant Abdominal Pain

Single Most Likely Diagnosis

  • Appendicitis: The most common cause of right lower quadrant abdominal pain, especially in a 34-year-old male. The pain often starts around the navel and then moves to the right lower quadrant, and is typically accompanied by fever, nausea, and vomiting.

Other Likely Diagnoses

  • Mesenteric Lymphadenitis: Inflammation of the lymph nodes in the mesentery, often caused by a viral or bacterial infection. It can mimic appendicitis in presentation.
  • Intestinal Obstruction: A blockage in the small or large intestine can cause severe abdominal pain, nausea, vomiting, and constipation.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, diarrhea, and weight loss.
  • Ovarian Torsion (in females, but can be considered in differential for abdominal pain): Although the patient is male, it's essential to consider ovarian torsion in the differential for abdominal pain in general, but it's less likely in this case.

Do Not Miss Diagnoses

  • Ectopic Pregnancy (in females, but important to consider in abdominal pain): Again, while the patient is male, ectopic pregnancy is a critical diagnosis to consider in the differential for severe abdominal pain, especially in females of childbearing age.
  • Ruptured Aortic Aneurysm: A life-threatening condition that requires immediate attention. Although it's more common in older adults, it's crucial not to miss this diagnosis.
  • Diverticulitis: Inflammation of the diverticula in the colon, which can cause severe abdominal pain, fever, and changes in bowel habits.
  • Hernia (incarcerated or strangulated): A hernia that becomes trapped or cuts off blood supply to the intestine can cause severe pain and requires emergency attention.

Rare Diagnoses

  • Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, nausea, and vomiting, often in younger patients.
  • Carcinoid Tumor: A rare tumor of the neuroendocrine system that can cause abdominal pain, flushing, and diarrhea.
  • Intussusception: A condition where a part of the intestine telescopes into another part, causing severe abdominal pain, vomiting, and bloody stools.
  • Right Lower Quadrant Pain due to a Urinary Tract Issue (e.g., kidney stone or pyelonephritis): Although the pain is typically more flank-like, it can sometimes be referred to the right lower quadrant.

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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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