Various conditions can cause left lower quadrant (LLQ) abdominal pain. An accurate diagnosis of LLQ pain can sometimes be difficult because of the number of organs that are in this region of the abdomen. The possibilities as to the cause of LLQ pain also vary depending on gender and age. Female reproductive organs increase the number of possibilities that must be considered. The differentiation between the causes of LLQ pain is made by careful history taking, thorough examination and appropriate laboratory tests.
Perhaps the most common cause of LLQ pain is the inflammation of diverticular disease, also called diverticulitis. This inflammation of small pouches on the colon wall is the result of increased pressure in the colon. Diverticular disease is quite common and is found primarily in people over 50 years of age who have a low-fiber diet. It generally does not cause any symptoms until the diverticulae become inflamed and infected. Acute diverticulitis was once called left-sided appendicitis, as the pain mirrors the location of an inflamed appendix.
Another GI cause of LLQ pain is colon cancer, but this is a rare complication of the disease.
Urinary Tract Causes
A relatively common cause of LLQ pain in both men and women is stones in the urinary tract, particularly stones in the left ureter, one of the tubes that transport urine from the kidney to the bladder. The pain from these stones can be quite debilitating, necessitating an emergency room visit. There may be associated symptoms of blood in the urine, nausea and vomiting.
Infections of the left kidney and the bladder may also cause LLQ pain, simply because of the location of these organs. Quite often these infections are associated with other symptoms, such as pain on urinating, foul-smelling urine, discolored urine and fever.
A tumor in the left kidney may also cause LLQ pain, although this is more likely to cause left flank pain.
In women, conditions affecting several of the reproductive organs may cause LLQ pain. Acute pelvic inflammatory disease, an infection of the uterus and fallopian tubes, is one such condition. A left-sided ectopic pregnancy, or torsion of a left ovarian cyst or of the left ovary itself, may all present with left lower quadrant pain. Torsion of the ovary occurs when the ovary becomes twisted, compromising its own blood supply. If left untreated, it may lead to death of the ovary and decreased fertility.
- "Sabiston Textbook of Surgery"; Townsend Jr., C et al.; 2008
- "Washington Manual of Surgery"; Doherty, G.M. et al; 2002