Differential Diagnosis for Left Lower Quadrant (LLQ) Pain
Single Most Likely Diagnosis
- Diverticulitis: The most common cause of LLQ pain, especially in older adults, due to inflammation of the diverticula in the sigmoid colon. The pain is typically constant and can be accompanied by changes in bowel habits, fever, and nausea.
Other Likely Diagnoses
- Constipation: Can cause LLQ pain due to the accumulation of stool in the sigmoid colon, which can lead to discomfort and pain.
- Irritable Bowel Syndrome (IBS): A common condition characterized by abdominal pain, bloating, and changes in bowel habits, which can manifest as LLQ pain.
- Ovarian Cyst: A possible cause of LLQ pain in females, especially if the cyst ruptures or becomes twisted.
- Kidney Stone: A stone in the left ureter can cause severe LLQ pain, often radiating to the groin.
Do Not Miss Diagnoses
- Ectopic Pregnancy: A life-threatening condition that can cause LLQ pain in females, especially if the pregnancy ruptures.
- Appendicitis (with atypical presentation): Although appendicitis typically presents with right lower quadrant pain, it can occasionally present with LLQ pain if the appendix is retrocecal.
- Intestinal Obstruction: A blockage in the intestine can cause severe LLQ pain, vomiting, and constipation.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic LLQ pain, diarrhea, and weight loss.
Rare Diagnoses
- Colonic Cancer: A rare cause of LLQ pain, but important to consider in older adults or those with a family history.
- Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, causing chronic LLQ pain and other symptoms.
- Inferior Mesenteric Artery Occlusion: A rare condition where the artery supplying blood to the colon becomes blocked, causing severe LLQ pain and potentially leading to bowel ischemia.