What is the cause of left lower quadrant (LLQ) pain?

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Last updated: April 16, 2025View editorial policy

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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, in some cases, the appendix can be located in the LLQ, causing pain in this area.
    • Intestinal Obstruction: A blockage in the intestines can cause severe abdominal pain, vomiting, and constipation, and requires immediate medical attention.
    • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic LLQ pain, diarrhea, weight loss, and fatigue.
  • Rare diagnoses
    • Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, causing pain, especially during menstruation.
    • Inguinal Hernia: A protrusion of tissue through a weak spot in the abdominal muscles, which can cause pain and discomfort in the groin area, potentially radiating to the LLQ.
    • Lymphoma: A type of cancer that can cause abdominal pain, weight loss, and fatigue, among other symptoms.
    • Intussusception: A condition where a part of the intestine slides into an adjacent part, causing bowel obstruction and severe abdominal pain.

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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