Right lower quadrant abdominal pain

Background

• This page describes the general approach to RLQ pain in adults

Clinical Features

• Right lower quadrant abdominal pain

Differential Diagnosis

RLQ Pain

• GI
  • Appendicitis
    • Perforated appendicitis
  • Peritonitis
  • Crohn's disease (terminal ileitis)
  • Diverticulitis (cecal, Asian patients)
  • Inguinal hernia
  • Mesenteric ischemia
  • Ischemic colitis
  • Meckel's diverticulum
  • Neutropenic enterocolitis (typhlitis)
• GU
  • Ectopic
  • Endometriosis
  • Kidney stone
  • Mittelschmerz
  • Ovarian cyst
  • Ovarian torsion
  • PID
  • Pyelonephritis
• Other
  • Abdominal aortic aneurysm
  • Epiploic appendagitis
  • Mesenteric lymphadenitis
  • Herpes zoster
  • Psoas abscess
  • Testicular torsion

Workup

Male

• CBC
• Chem
• Urinalysis
• ?CT abd/pelvis (rule out appy)
• Testicular exam

Female

• CBC
• Chem
• Urinalysis
• Urine pregnancy
• ?Pelvic ultrasound (rule out ovarian torsion) and/or CT abd/pelvis (rule out appy)
• Pelvic exam

Management

• Treat underlying disease process

Disposition

• Per underlying disease process

See Also

• Abdominal Pain
• Abdominal Pain (Peds)