Differential Diagnosis for 28-year-old Female with Sudden Onset Abdominal Pain in Right Lower Quadrant
Single Most Likely Diagnosis
- Appendicitis: This is the most common cause of acute right lower quadrant abdominal pain, especially in young adults. The sudden onset of pain, initially diffuse and then localizing to the right lower quadrant, is a classic presentation.
Other Likely Diagnoses
- Ovarian Cyst Rupture or Torsion: These conditions can cause severe, sudden abdominal pain and are more common in women of reproductive age. The pain is often localized to the lower abdomen and can be accompanied by nausea and vomiting.
- Ectopic Pregnancy: Although less common, ectopic pregnancy should be considered in any woman of childbearing age presenting with abdominal pain, especially if there's a possibility of pregnancy. The pain can be sudden and severe, often accompanied by vaginal bleeding.
- Gastrointestinal Obstruction: This can cause severe abdominal pain, nausea, vomiting, and constipation. The pain can be localized to the right lower quadrant if the obstruction is in the ileum or cecum.
Do Not Miss Diagnoses
- Ruptured Ectopic Pregnancy: This is a life-threatening condition that requires immediate surgical intervention. Missing this diagnosis can lead to severe hemorrhage and death.
- Intestinal Ischemia: This condition can cause severe abdominal pain and is often accompanied by bloody diarrhea. It's crucial to diagnose promptly as it can lead to bowel necrosis and perforation if not treated.
- Pulmonary Embolism: Although less common, pulmonary embolism can cause sudden onset of abdominal pain if the embolus lodges in a pulmonary artery branch that irritates the diaphragm, causing referred pain to the abdomen.
Rare Diagnoses
- Meckel's Diverticulitis: This is a rare condition where a congenital diverticulum of the small intestine becomes inflamed, causing abdominal pain, often in the right lower quadrant.
- Endometriosis: Although not typically causing sudden onset pain, endometriosis can cause chronic pelvic pain that occasionally becomes acute. It's more common in women of reproductive age.
- Inflammatory Bowel Disease (IBD) Flare: Conditions like Crohn's disease or ulcerative colitis can cause abdominal pain, but the onset is usually more gradual. However, a flare can cause sudden worsening of symptoms.