Differential Diagnosis for Lower Abdominal Pain
Single Most Likely Diagnosis
- Appendicitis: This is often the first consideration for lower abdominal pain, especially if the pain is localized to the right lower quadrant. Appendicitis is a common and potentially serious condition that requires prompt medical attention.
Other Likely Diagnoses
- Urinary Tract Infection (UTI): UTIs are common, especially in women, and can cause lower abdominal pain, often accompanied by dysuria, frequency, and urgency.
- Ovarian Cyst: Ovarian cysts can cause lower abdominal pain, and while many are benign, they can rupture or twist, leading to an emergency.
- Diverticulitis: Inflammation of the diverticula in the colon can cause lower abdominal pain, usually on the left side, and is more common in older adults.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic lower abdominal pain, diarrhea, and weight loss.
Do Not Miss Diagnoses
- Ectopic Pregnancy: Although less common, an ectopic pregnancy is a life-threatening condition that must be considered, especially in women of childbearing age presenting with lower abdominal pain and a positive pregnancy test.
- Ruptured Aneurysm: A ruptured abdominal aortic aneurysm can cause severe lower abdominal pain and is immediately life-threatening.
- Intestinal Obstruction: This can cause severe abdominal pain, vomiting, and constipation, and requires urgent medical attention to prevent complications.
- Ovarian Torsion: Twisting of the ovary can cut off its blood supply, leading to severe pain and requiring emergency surgery.
Rare Diagnoses
- Endometriosis: While not rare, endometriosis causing lower abdominal pain can sometimes be overlooked. It's characterized by chronic pain, dysmenorrhea, and dyspareunia.
- Lymphoma: Abdominal lymphoma can cause lower abdominal pain, but it's much less common than other causes.
- Pneumatosis Cystoides Intestinalis: A rare condition characterized by the presence of gas-filled cysts in the intestinal wall, which can cause abdominal pain.
- Malrotation of the Gut: A congenital anomaly that can cause intestinal obstruction and abdominal pain, more commonly diagnosed in children but can be missed in adults.