right lower quadrant pain

Etiology

• pain may originate within the distal intestinal tract
  • appendicitis
  • when occuring together with diarrhea suggests
    • colitis
    • ileitis
  • intestinal causes may be:
    • infectious (see enterocolitis)
    • ischemic bowel
    • inflammatory bowel disease
    • malignant, colon cancer
    • medication induced
• pain may radiate down from upper abdominal structures (see abdominal pain)
• pain may radiate up from pelvis (see pelvic pain)

Clinical manifestations

• diarrhea would suggest colitis, ileitis

Laboratory

• complete blood count (CBC)
• iron studies if anemia identified
• pregnancy test in women (also see pelvic pain)
• urinalysis
• stool studies
  • stool ova & parasites
  • fecal leukocytes
  • stool culture for enteric pathogens
  • C-difficile toxin
  • fecal occult blood
• see abdominal pain
• see pelvic pain

Diagnostic procedures

• colonoscopy if needed to establish diagnosis

Radiology

• computed tomography
• see abdominal pain

Differential diagnosis

• appendicitis (24%)
• diagnoses other than appendicitis (32%)
  • spectrum of pelvic pain
    • adnexal abnormalities in women (33%)
  • inflammatory enteritis or adenitis (17%)
  • urolithiasis (12%)
  • diverticulitis (8%)
  • constipation (7%)
  • small bowel obstruction (4%)
  • inflammatory bowel disease (4%)
  • abdominal pain (referred pain) from upper abdomen
    • cholecystitis (4%)
• no specific diagnoses (35%)

Notes

• visceral pain localizes poorly in the abdomen
• consider all possible sources of abdominal pain

More general terms

• abdominal pain

Additional terms

• right lower quadrant (RLQ)