Differential Diagnosis for Lower Quadrant Abdominal Pain Worse When Laying Supine

• Single Most Likely Diagnosis
  • Appendicitis: This condition often presents with lower quadrant abdominal pain, particularly in the right lower quadrant, and can worsen when the patient is in a supine position due to increased pressure on the inflamed appendix.
• Other Likely Diagnoses
  • Ovarian cyst or torsion: These conditions can cause lower abdominal pain that may worsen with movement or position change, including laying supine, due to the increased pressure on the ovaries.
  • Diverticulitis: Inflammation of the diverticula in the colon can cause lower quadrant abdominal pain, which may be exacerbated by certain positions, including laying supine.
  • Ectopic pregnancy: Although more commonly associated with missed periods and vaginal bleeding, ectopic pregnancy can cause lower abdominal pain that worsens with movement or position change.
• Do Not Miss Diagnoses
  • Ruptured abdominal aortic aneurysm: A life-threatening condition that can present with severe abdominal pain, which may worsen with position change, including laying supine. Immediate diagnosis and treatment are crucial.
  • Ectopic pregnancy with rupture: Similar to a ruptured abdominal aortic aneurysm, a ruptured ectopic pregnancy is a medical emergency requiring immediate attention.
  • Intestinal obstruction: This condition can cause severe abdominal pain, vomiting, and constipation, and certain positions may exacerbate the pain.
• Rare Diagnoses
  • Endometriosis: While endometriosis can cause chronic pelvic pain, it is less likely to cause acute lower quadrant abdominal pain that worsens with laying supine.
  • Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis): These conditions can cause chronic abdominal pain and may have acute exacerbations, but they are less likely to present with pain that specifically worsens in the supine position.