A pre-hospital team is called to a 70-year-old male who presents with sudden onset of right lower quadrant abdominal pain, tenderness, and guarding. H...

Question

A pre-hospital team is called to a 70-year-old male who presents with sudden onset of right lower quadrant abdominal pain, tenderness, and guarding. He has a temperature of 38.5°C and is haemodynamically stable. He has a history of chronic constipation. What is the most likely diagnosis?

Accepted Answer

Acute diverticulitis - right-sided diverticulitis is less common than left-sided but occurs, particularly in Asian populations; however, in Western patients, right lower quadrant pain with peritonism should also raise suspicion of caecal pathology, appendicitis (which can occur in the elderly), or inflammatory bowel disease

Answer

Acute appendicitis is excluded by the patient's age

Answer

Right renal colic - the most common cause of right lower quadrant pain in the elderly

Answer

Mesenteric ischaemia - pain is always in the right lower quadrant

Answer

Irritable bowel syndrome flare

uk-dipimc MCQ (SBA): Right Lower Quadrant Pain - Elderly

A pre-hospital team is called to a 70-year-old male who presents with sudden onset of right lower quadrant abdominal pain, tenderness, and guarding. He has a temperature of 38.5°C and is haemodynamically stable. He has a history of chronic constipation. What is the most likely diagnosis?