Differential Diagnosis for Right Lower Abdominal Pain Radiating to the Back in a 6-7 Weeks Pregnant Woman

Single Most Likely Diagnosis

• Appendicitis: This is a common cause of right lower abdominal pain, especially in the second trimester of pregnancy, but it can occur at any gestational age. The pain often starts near the navel and then moves to the right lower abdomen. Pregnancy can sometimes make the diagnosis more challenging due to the displacement of the appendix by the growing uterus.

Other Likely Diagnoses

• Urinary Tract Infection (UTI) or Pyelonephritis: These conditions can cause lower abdominal pain that may radiate to the back. Pregnancy increases the risk of UTIs due to physiological changes that affect the urinary tract.
• Kidney Stones: Although not as common in early pregnancy, kidney stones can cause severe pain that radiates from the abdomen to the back. The pain can be intermittent and may be accompanied by nausea, vomiting, and urinary symptoms.
• Ovarian Cyst or Torsion: Ovarian cysts are common in pregnancy and can cause pain if they rupture or torsion occurs. The pain is usually acute and can radiate to the back.

Do Not Miss Diagnoses

• Ectopic Pregnancy: Although the patient is 6-7 weeks pregnant and might have already had an ultrasound confirming an intrauterine pregnancy, ectopic pregnancy should always be considered in the differential diagnosis of abdominal pain in early pregnancy, especially if there's any suspicion of a ruptured ectopic pregnancy.
• Placental Abruption: This condition involves the premature separation of the placenta from the uterus and can cause abdominal pain and vaginal bleeding. It's a medical emergency.
• Pulmonary Embolism: Pregnancy increases the risk of thromboembolic events. While pulmonary embolism typically presents with respiratory symptoms, it can sometimes cause abdominal pain if the embolism affects the lung bases.

Rare Diagnoses

• Hepatic Hemangioma or Other Liver Pathologies: These are benign tumors of the liver that can cause pain if they rupture or bleed. They are rare and not typically associated with pregnancy but should be considered in the differential diagnosis of right upper quadrant pain.
• Adrenal Gland Pathology: Rare conditions affecting the adrenal glands, such as pheochromocytoma or adrenal hemorrhage, can cause abdominal or back pain. These conditions are uncommon and might not be directly related to pregnancy but are important to consider in a comprehensive differential diagnosis.