Differential Diagnosis for Acute Sharp Pain in the L Lower Quadrant
- Single most likely diagnosis
- Diverticulitis: This condition is a common cause of acute sharp pain in the left lower quadrant, especially in older adults. The pain is often accompanied by changes in bowel habits, fever, and nausea.
- Other Likely diagnoses
- Kidney stone (ureterolithiasis): A stone in the left ureter can cause severe, sharp pain that radiates to the left lower quadrant. The pain is often accompanied by nausea, vomiting, and urinary frequency.
- Ovarian cyst or torsion: In females, a ruptured ovarian cyst or ovarian torsion can cause acute sharp pain in the left lower quadrant, often accompanied by nausea, vomiting, and abdominal tenderness.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause acute abdominal pain, including in the left lower quadrant, along with changes in bowel habits, weight loss, and fatigue.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ectopic pregnancy: Although less common, an ectopic pregnancy can cause acute sharp pain in the left lower quadrant, especially in females of childbearing age. This condition is life-threatening and requires immediate medical attention.
- Ruptured abdominal aortic aneurysm (AAA): A ruptured AAA can cause severe, sharp pain in the left lower quadrant, often accompanied by hypotension, tachycardia, and a palpable abdominal mass.
- Intestinal ischemia or infarction: Reduced blood flow to the intestines can cause acute abdominal pain, including in the left lower quadrant, along with nausea, vomiting, and abdominal tenderness.
- Rare diagnoses
- Splenic infarction or rupture: Although rare, a splenic infarction or rupture can cause acute sharp pain in the left lower quadrant, often accompanied by nausea, vomiting, and abdominal tenderness.
- Left-sided inguinal hernia: A rare cause of acute sharp pain in the left lower quadrant, especially if the hernia becomes incarcerated or strangulated.