Differential Diagnosis
- Single most likely diagnosis
- Ovarian cyst: Given the patient's history of cysts and symptoms of bloating and lower left quadrant (LLQ) pain, an ovarian cyst is a plausible explanation. The patient's regular menstrual period suggests that the cyst is likely benign, but it could still cause discomfort and pain.
- Other Likely diagnoses
- Constipation: Bloating and LLQ pain can also be symptoms of constipation, which is a common condition that can be exacerbated by hormonal changes during the menstrual cycle.
- Irritable Bowel Syndrome (IBS): IBS is a chronic condition that can cause bloating, abdominal pain, and changes in bowel habits. The patient's symptoms could be consistent with IBS, especially if she has a history of similar symptoms.
- Pelvic adhesions: The patient's history of tubal ligation and possible previous pelvic surgeries could have led to the formation of pelvic adhesions, which can cause pain and bloating.
- Do Not Miss
- Ectopic pregnancy: Although the patient had a tubal ligation, there is still a small chance of an ectopic pregnancy, which can be life-threatening if not diagnosed promptly. The patient's symptoms of LLQ pain and bloating could be consistent with an ectopic pregnancy.
- Ovarian torsion: If the patient has an ovarian cyst, there is a risk of ovarian torsion, which can cause severe pain and require emergency surgery.
- Appendicitis: Although the patient's pain is in the LLQ, appendicitis can sometimes present with pain in this location, and it is a medical emergency that requires prompt treatment.
- Rare diagnoses
- Endometriosis: Although the patient has a history of regular periods, endometriosis can still cause symptoms of bloating and LLQ pain, especially if the endometrial implants are located in the bowel or bladder.
- Diverticulitis: This is a condition where the diverticula in the colon become inflamed, causing pain, bloating, and changes in bowel habits. It is less likely in this patient, but could be considered if other diagnoses are ruled out.