Objective: Recognize causes  of abdominal pain in different  quadrants.

Explanation:

For differential diagnosis purposes let us see the abdomen in 4 anterior quadrants and the left and right flanks.

RUQ-perihepatic structures
Liver- hepatitis, Budd chiari(esp if pt. has Nephrotic/paroxysmal nocturnal hemoglobinuria), ruptured hepatic adenoma(young female on oral contraceptives), hepatic trauma, Perihepatitis(e.g. Fitz-Hugh-Curtis syndrome-chlamydia or gonococcus).

Gall bladder- calculous or non calculous(esp in pt in ICU or on cephalosporins) cholecystitis,Gallstone colic

Duodenum-ulcer (on exams- think of Zolinger Ellison)

Lung base- Lower lobe pneumonia, pleuritis

Diaphragm-irritation due to blood in peritoneum(also pain in Right shoulder when patient is in head low position-esp seen in splenic rupture-inspite of spleen being left sided)

RLQ: Structures around cecum and those on right side of uterus.

Appendix-Appendicitis-acute or chronic

Cecum-Typhilitis esp in post chemotherapy patient - occurs with Pseudomonas and Clostridium septicum with approximately equal frequency.

Ovary- cyst rupture or torsion, fibroid- red degeneration, ECTOPIC pregnancy, Tubo-ovarian abscess(PID)

GIT-rarely diverticulitis(usually occurs on left side).

LUQ: Spleen and structures around it.

Stomach, Spleen, pancreas, colon-splenic flexure

LLQ:

Sigmoid colon- especially diverticulitis that is seen in elderly population and is treated with antibiotics, hydration-PO or IV and stool softening. Encourage fiber in diet.

Uterine structures-as in LLQ area.