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Differential Diagnosis for Right Lower Quadrant (RLQ) Pain

Single Most Likely Diagnosis

  • Appendicitis: This is the most common cause of RLQ pain, especially in younger individuals. The pain often starts around the navel and then moves to the RLQ. Appendicitis requires prompt medical attention to prevent rupture.

Other Likely Diagnoses

  • Ovarian Cyst or Torsion: In females, ovarian cysts can cause RLQ pain, especially if they rupture or torsion occurs. The pain can be severe and is often accompanied by nausea and vomiting.
  • Ectopic Pregnancy: Another condition in females, ectopic pregnancy can cause RLQ pain due to the implantation of the embryo outside the uterus, often in the fallopian tube.
  • Diverticulitis: Inflammation of the diverticula in the colon can cause pain in the RLQ, especially if the affected diverticula are in the sigmoid colon, which can sometimes refer pain to the RLQ.
  • Intestinal Obstruction: Obstruction of the small or large intestine can cause severe abdominal pain, including in the RLQ, depending on the location of the obstruction.

Do Not Miss Diagnoses

  • Ectopic Pregnancy: Although mentioned earlier, it's crucial to reiterate due to its potential for severe consequences if missed, including rupture and severe hemorrhage.
  • Ruptured Ovarian Cyst: Similar to ectopic pregnancy, a ruptured ovarian cyst can lead to significant internal bleeding and requires immediate medical intervention.
  • Appendiceal Rupture: If appendicitis is not treated promptly, the appendix can rupture, leading to peritonitis, a potentially life-threatening condition.
  • Mesenteric Ischemia: Reduced blood flow to the intestines can cause severe abdominal pain, including in the RLQ, and can lead to bowel infarction if not promptly addressed.

Rare Diagnoses

  • Meckel's Diverticulum: A congenital anomaly of the small intestine, Meckel's diverticulum can cause pain, especially if it becomes inflamed or if there's bleeding.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic abdominal pain, including in the RLQ, though the pain is typically more diffuse.
  • Ureteral Stone: A stone passing through the ureter can cause severe, colicky pain that may radiate to the RLQ if the stone is in the distal ureter.
  • Yersinia Ileitis: A rare cause of RLQ pain, Yersinia ileitis is an infection of the ileum caused by the bacterium Yersinia enterocolitica.

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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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