Differential Diagnosis for Left Quadrant Pain

The differential diagnosis for left quadrant pain can be organized into the following categories:

• Single Most Likely Diagnosis
  • Diverticulitis: This is a common cause of left lower quadrant pain, especially in older adults. The pain is often accompanied by changes in bowel habits, fever, and abdominal tenderness.
• Other Likely Diagnoses
  • Constipation: Severe constipation can cause significant left lower quadrant pain due to the accumulation of feces in the sigmoid colon.
  • Irritable Bowel Syndrome (IBS): IBS can cause recurring abdominal pain, including left quadrant pain, often accompanied by changes in bowel habits.
  • Kidney Stone: A kidney stone in the left ureter can cause severe left flank pain that may radiate to the left lower quadrant.
  • Ovarian Cyst (in females): An ovarian cyst can cause left lower quadrant pain, especially if it ruptures or becomes twisted.
• Do Not Miss Diagnoses
  • Ectopic Pregnancy (in females): Although less common, an ectopic pregnancy can cause severe left lower quadrant pain and is a life-threatening condition if not promptly diagnosed and treated.
  • Appendicitis (if the appendix is located in the left lower quadrant): Although the appendix is typically located in the right lower quadrant, in some cases it can be found in the left lower quadrant, causing left-sided pain.
  • Intestinal Obstruction: An obstruction in the left colon can cause severe pain, vomiting, and constipation, and is a medical emergency.
  • Sigmoid Volvulus: A twisting of the sigmoid colon can cause severe left lower quadrant pain, vomiting, and constipation, and requires prompt treatment.
• Rare Diagnoses
  • Inflammatory Bowel Disease (e.g., Crohn's disease, ulcerative colitis): These conditions can cause chronic left quadrant pain, diarrhea, and weight loss.
  • Left-sided inguinal hernia: A hernia in the left groin area can cause left lower quadrant pain, especially when coughing or straining.
  • Splenic Infarction: A blockage of the splenic artery can cause severe left upper quadrant pain, which may radiate to the left lower quadrant.
  • Pancreatitis: Inflammation of the pancreas can cause severe left upper quadrant pain that may radiate to the back and left lower quadrant.