CLINICAL DIAGNOSTIC MANUAL
Localized tenderness in the lower quadrants of the abdomen, either right or left, is a common symptom in various pathologies affecting the organs and anatomical structures in these areas.
The lower abdominal quadrants house important structures such as the intestines, appendix, ovaries, and fallopian tubes in women, as well as parts of the urinary system.
Pain in these quadrants can be acute or chronic and may be accompanied by other symptoms such as fever, changes in bowel habits, or urinary symptoms. A detailed diagnostic approach is essential to identify the underlying cause and provide appropriate treatment.
Pathology | Symptoms and Clinical Signs | Suspicion Diagnosis | Confirmatory Diagnosis |
Appendicitis | Pain that begins in the epigastrium and migrates to the right lower quadrant, fever, nausea | Clinical history, physical examination, complete blood count | Abdominal CT scan |
Diverticulitis | Pain in the left lower quadrant, fever, changes in bowel habits, nausea | Clinical history, physical examination, complete blood count | Abdominal CT scan |
Ectopic Pregnancy | Acute pelvic pain, vaginal bleeding, dizziness, hypotension | Clinical history, gynaecological examination, pregnancy test | Transvaginal ultrasound, serum hCG levels |
Ovarian Cysts | Pelvic pain, abdominal distension, menstrual irregularities | Clinical history, gynaecological examination | Pelvic ultrasound, magnetic resonance imaging (MRI) |
Pelvic Inflammatory Disease | Pelvic pain, fever, abnormal vaginal discharge, dyspareunia, dysuria | Clinical history, physical examination, complete blood count, urinalysis | Vaginal secretion culture, pelvic ultrasound |
Inguinal Hernia | Groin pain, visible or palpable lump in the inguinal area, increased pain with exertion | Clinical history, physical examination | Abdominal ultrasound, abdominal CT scan |
Cystitis | Dysuria, urinary frequency, suprapubic pain, haematuria, fever | Clinical history, physical examination, urinalysis | Urine culture, urinary tract ultrasound |
Pyelonephritis | Fever, flank pain, dysuria, nausea, vomiting | Clinical history, physical examination, urinalysis, complete blood count | Urine culture, abdominal CT scan |
Endometriosis | Chronic pelvic pain, dysmenorrhoea, dyspareunia, infertility | Clinical history, gynaecological examination | Laparoscopy, pelvic ultrasound |
Irritable Bowel Syndrome | Chronic abdominal pain, changes in bowel habits, abdominal distension, relief with defecation | Clinical history, physical examination | Clinical diagnosis, tests to exclude other pathologies |
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