Advanced Medical Life Support (AMLS)

Which condition should be included in the differential diagnosis for a patient with sharp left lower abdominal pain that intensifies with palpation?

1. Ectopic pregnancy or diverticulitis

2. Pancreatitis or gall bladder infection

3. Peritonitis or intestinal obstruction

4. Appendicitis or hepatitis

The correct answer is: Ectopic pregnancy or diverticulitis

The inclusion of ectopic pregnancy or diverticulitis in the differential diagnosis for a patient experiencing sharp left lower abdominal pain that intensifies with palpation is appropriate due to the specific characteristics of these conditions and their anatomical relevance. Ectopic pregnancy is a critical consideration, especially in women of childbearing age. It occurs when a fertilized egg implants outside the uterus, often in a fallopian tube, leading to severe abdominal pain. If the ectopic pregnancy ruptures, it can cause significant pain and internal bleeding, particularly felt on the side where the ectopic is located. This pain typically intensifies upon palpation. Diverticulitis, which involves the inflammation of diverticula in the colon (often found in the sigmoid colon, located in the left lower abdomen), also presents with sharp, localized pain. Patients may experience tenderness upon palpation in the affected area, further supporting its inclusion in the differential diagnosis. While pancreatitis, gall bladder infection, peritonitis, intestinal obstruction, appendicitis, and hepatitis are all important conditions to consider in abdominal pain scenarios, the specific location and pain response guide the focus toward ectopic pregnancy and diverticulitis in this case.