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Last updated: October 15, 2025View editorial policy

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Differential Diagnosis for LLQ Pain

Single Most Likely Diagnosis

  • Diverticulitis: This is a common cause of left lower quadrant (LLQ) pain, especially in older adults. The sharp pain is consistent with inflammation of the diverticula in the sigmoid colon.

Other Likely Diagnoses

  • Constipation: Severe constipation can cause sharp pain in the LLQ due to the buildup of stool in the sigmoid colon.
  • Irritable Bowel Syndrome (IBS): IBS can cause sharp abdominal pain, including in the LLQ, often accompanied by changes in bowel habits.
  • Ovarian Cyst: A ruptured or torsed ovarian cyst can cause sharp pain in the LLQ in females.
  • Kidney Stone: A stone in the left ureter can cause sharp pain in the LLQ, often radiating to the groin.

Do Not Miss Diagnoses

  • Ectopic Pregnancy: A life-threatening condition that can cause sharp LLQ pain in females, especially if there is a history of missed periods or positive pregnancy test.
  • Appendicitis (atypical presentation): Although appendicitis typically presents with right lower quadrant pain, an atypical presentation can occur, especially if the appendix is retrocecal.
  • Intestinal Obstruction: A mechanical obstruction of the intestine can cause severe, sharp pain in the LLQ, often accompanied by vomiting and constipation.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause sharp LLQ pain, often accompanied by diarrhea, weight loss, and fever.

Rare Diagnoses

  • Inferior Mesenteric Artery Embolism: A rare condition that can cause sharp LLQ pain due to embolism of the inferior mesenteric artery.
  • Colonic Volvulus: A rare condition where the colon twists, causing sharp pain in the LLQ.
  • Endometriosis: A rare cause of sharp LLQ pain in females, often accompanied by heavy menstrual bleeding and infertility.
  • Lymphoma: A rare cause of sharp LLQ pain due to lymphoma involving the intestines or lymph nodes in the abdomen.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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