Differential Diagnosis for Vaginal Bleeding and Right Lower Quadrant Pain
Single Most Likely Diagnosis
- Ectopic Pregnancy: This condition is a leading cause of vaginal bleeding and lower abdominal pain, particularly in women of reproductive age. The right lower quadrant pain could be due to the location of the ectopic pregnancy or referred pain from the pelvis.
Other Likely Diagnoses
- Ovarian Cyst Rupture or Torsion: These conditions can cause sudden onset of right lower quadrant pain and may be associated with vaginal bleeding, especially if there is an ovarian cyst that is also affecting the uterus or other pelvic structures.
- Miscarriage: Spontaneous abortion can present with vaginal bleeding and may be accompanied by lower abdominal pain, including right lower quadrant pain, depending on the extent of the miscarriage and the body's response.
- Pelvic Inflammatory Disease (PID): PID can cause lower abdominal pain, which may be localized to one side, and can be associated with vaginal bleeding, especially if there is an associated infection of the uterus or cervix.
Do Not Miss Diagnoses
- Ruptured Appendicitis: Although appendicitis typically presents with right lower quadrant pain and may not initially have vaginal bleeding, a ruptured appendix can lead to peritonitis, which can cause referred pain and potentially vaginal bleeding due to the proximity of the appendix to the female reproductive organs.
- Ovarian Tumor: While less common, an ovarian tumor can cause both vaginal bleeding and abdominal pain, including right lower quadrant pain, and is critical to diagnose due to its potential for malignancy.
Rare Diagnoses
- Hemorrhagic Ovarian Cyst: A less common cause of acute abdominal pain and vaginal bleeding, a hemorrhagic ovarian cyst can rupture and cause severe pain and bleeding.
- Ureteral Injury or Disease: Conditions affecting the ureters, such as a stone or injury, can cause lower abdominal pain and, in rare cases, may be associated with vaginal bleeding if there is an associated infection or anatomical anomaly.
- Gastrointestinal Causes: Certain gastrointestinal conditions, like a Meckel's diverticulum or intestinal obstruction, can cause lower abdominal pain and, in rare instances, may be associated with vaginal bleeding, especially if there is a fistula or other abnormal connection between the gastrointestinal and reproductive systems.