In sudden LLQ pain, which could be a diagnosis?

• A. Hemorrhagic cyst or ovarian torsion of the left side
• B. Appendicitis
• C. Ureteral stone
• D. Gastritis

Answer: (A)

Sudden unilateral lower-quadrant pelvic pain points you toward ovarian causes on that side. A hemorrhagic ovarian cyst or an ovarian torsion on the left can both present with abrupt, severe pain and adnexal tenderness. Ovarian torsion is an emergency where the ovary twists and blood supply is compromised, often causing sudden, intense pain with possible nausea or vomiting. Hemorrhagic cyst rupture can produce sudden pelvic pain as a follicle bleeds into the abdomen, sometimes with free fluid seen on ultrasound.

Consider the other options: appendicitis typically starts around the navel and then localizes to the right lower quadrant, making left-sided sudden pain less likely. A ureteral stone can cause sudden severe pain as well, but it’s usually described as flank or groin pain and may be accompanied by hematuria. Gastritis causes more epigastric or diffuse abdominal discomfort rather than sudden pelvic pain.

So for sudden left lower quadrant pain, left ovarian pathology—such as a hemorrhagic cyst or torsion—best fits the presentation.