03 November 2007

Mnemonic Series No. 13: RLQ Pain

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Proper Assessment of the patient means right diagnosis and treatment. Pain is one of the most common subjective complains we ever received in ER. When assessing patient with a complain of a Right Lower Quadrant pain, the first thing that would come to our mind as a differential diagnosis is APPENDICITIS. And it is very true! See the Mnemonic below!
RLQ Pain: Differential Diagnosis APPENDICITIS

A- Appendicitis/Abscess

P- PID (Pelvic Inflammatory Disease)

P- Pancreatitis

E- Ectopic/Endometriosis

N- Neoplasia

D- Diverticulitis

I- Intussusception

C- Chron's Disease/Cyst, Ovarian

I- Irritable Bowel Syndrome

T- Torsion (Ovarian)

I- IBD (Inflammatory Bowel Disease)

S- Stones


Anonymous said...

im just wondering why pancreatitis is included.. isn't it chx by left upper quadrant pain?

Richelle said...

hi! tnx for that comment... here is the explaination about pancreatitis as one of the differential diagnosis of RLQ pain:
In some patients with perforated peptic ulcer, perforated cholecystitis, or pancreatitis, the clinical symptoms are similar to those of appendicitis because the gastric contents, bile, and pancreatic secretions descend along the paracolic gutter into the RLQ and cause chemical periappendicitis. A false-positive diagnosis of appendicitis may be made. In these conditions associated with fat stranding in the RLQ, the normal appearance of appendix helps to exclude appendicitis. www.medscape.com

Hope this can help u...

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