Differential Diagnosis for Left Lower Quadrant (LLQ) Pain
- Single most likely diagnosis
- Diverticulitis: This is a common cause of LLQ pain, especially in older adults. The pain is usually constant and accompanied by changes in bowel habits, fever, and nausea.
- Other Likely diagnoses
- Constipation: Hard stools or difficulty passing stools can cause significant pain in the LLQ, often accompanied by bloating and discomfort.
- Irritable Bowel Syndrome (IBS): Characterized by recurring abdominal pain associated with a change in bowel habits, such as diarrhea or constipation.
- Ovarian Cyst: In women, a ruptured or torsioned ovarian cyst can cause severe LLQ pain, often accompanied by nausea and vomiting.
- Kidney Stone: A stone in the left ureter can cause severe, colicky pain in the LLQ, radiating to the groin, accompanied by nausea, vomiting, and frequent urination.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ectopic Pregnancy: In women of childbearing age, a pregnancy developing outside the uterus can cause severe LLQ pain, vaginal bleeding, and can be life-threatening if not promptly treated.
- Appendicitis (if the appendix is located in the LLQ): Although appendicitis typically presents with right lower quadrant pain, an appendix located in the LLQ can cause pain in this area, and missing the diagnosis can lead to perforation and peritonitis.
- Intestinal Obstruction: A blockage in the intestines can cause severe abdominal pain, vomiting, and constipation, and requires immediate medical attention to prevent complications.
- Ruptured Aortic Aneurysm: A tear in the aorta can cause severe abdominal pain, often radiating to the back, and is a medical emergency.
- Rare diagnoses
- Inflammatory Bowel Disease (Crohn's Disease or Ulcerative Colitis): Chronic conditions that cause inflammation in the digestive tract, leading to abdominal pain, diarrhea, and weight loss.
- Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, causing pain, especially during menstruation.
- Colonic Cancer: Although less common, cancer in the colon can cause LLQ pain, changes in bowel habits, and weight loss, especially in older adults or those with a family history.