Right lower quadrant abdominal pain

Background

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

Classification by Abdominal pain location

Side-by-side comparison of quadrants and regions.

Chart of commonly reported referred pain sites.

RUQ pain	Epigastric pain	LUQ pain
Flank pain	Diffuse abdominal pain	Flank pain
RLQ pain	Pelvic pain	LLQ pain

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)