Differential Diagnosis for Left Side Intermittent Pulling Pain in a 30-Year-Old with Recent Miscarriage

Single Most Likely Diagnosis

• Residual products of conception: This condition is a likely cause of pain after a miscarriage, especially if a D&C was not performed. The body may be trying to expel remaining tissue, leading to intermittent pain.

Other Likely Diagnoses

• Pelvic adhesions: These can form after any pelvic event, including miscarriage, and may cause intermittent pulling pain.
• Ovarian cysts: These are common in women of reproductive age and can cause intermittent pain, especially if they rupture or twist.
• Constipation: This is a common issue that can cause abdominal pain and may be exacerbated by hormonal changes after a miscarriage.

Do Not Miss Diagnoses

• Ectopic pregnancy: Although less likely if a miscarriage has already been diagnosed, an ectopic pregnancy can still occur and is a life-threatening condition if not promptly treated.
• Appendicitis: This condition can present with abdominal pain and must be considered, especially if the pain becomes severe or persistent.
• Ovarian torsion: This is a rare but serious condition that requires immediate medical attention to preserve ovarian function.

Rare Diagnoses

• Endometriosis: While not directly related to the miscarriage, endometriosis can cause chronic pelvic pain and may be considered if other diagnoses are ruled out.
• Ureteral obstruction: This could be due to various causes, including a stone or adhesions, and would require specific diagnostic tests to identify.
• Diverticulitis: Although more common in older adults, diverticulitis can occur in younger individuals and would present with abdominal pain, possibly localized to the left side.