Right Lower Quadrant Abdominal Pain (RLQ)

Last updated 25.08.13

 

 

Definition

-  Abdominal pain arising on the right side lateral to midline, inferior to umbilicus & superior to inguinal ligament

 

Contents of RLQ of Abdomen

-  Terminal ileum

-  Caecum

-  Ascending colon

-  Right ovary + adnexa

-  Right ureter

 

Causes

-  Appendicitis

-  Mesenteric adenitis

-  Crohns disease

-  Ovarian pathology: cyst rupture, torsion

-  Testicular pathology: torsion, orchitis

-  PID

-  UTI

-  Bowel obstruction

-  Diverticulitis

-  Meckels diverticulum

 

DDx

-  Urolithiasis

-  Trochanteric bursitis

-  Hip pain

-  Pelvic pain

-  Herpes Zoster (Shingles) &/or PHN

-  Hernia: inguinal, femoral

 

Associated S/S

-  Fever

-  Nausea, vomiting

-  Diarrhoea

-  Haematuria, dysuria &/or frequency: UTI +/- PID

-  Abdo exam

-  Rebound &/or guarding: peritonitis

-  Board like rigidity: peritonitis

-  Mcburneys point tenderness: appendicitis

-  Rosvings sign: appendicitis

-  Testicle exam: exclude torsion

-  +/- Bimanual/VE: PID, torsion

 

Ix

-  FBE: WBC: infection/inflammation

-  CRP: inflammatory causes: UTI, PID, Appendicitis, Crohns..

-  Urine: dipstick +/- MSU for MCS: UTI

-  +/- CT-Abdo w contrast

 

Mx

-  Analgesia

-  NBM, IV access & IV fluids

-  Exclude acute abdomen & appendicitis first

 

 

 

References