Abdominal signs and symptoms can be from a wide variety of disease processes to include vascular, infectious, trauma, autoimmune, musculoskeletal, idiopathic, neoplastic, congenital, etc. The details below are not meant to serve as an exhaustive list; however, it should serve as a guide for commonly encountered pathology within their respective quadrants and can help guide clinical decision making, especially with regards to imaging and surgery.

Right upper quadrant (RUQ) pain

Commonly due to gastric reflux, gallbladder disease, hepatitis, peptic ulcer disease, pancreatitis, pyelonephritis, kidney stone, retrocecal appendicitis, or bowel obstructions

Right lower quadrant (RLQ) pain

Commonly due to appendicitis, Crohn disease, cecal diverticulitis, ectopic pregnancy, endometriosis, inguinal hernia, ischemic colitis, ovarian cyst, ovarian torsion, pelvic inflammatory disease, psoas abscess, testicular torsion, or kidney stones 

Left upper quadrant (LUQ) pain

Commonly due to gastric reflux, peptic ulcer disease, pancreatitis, splenic infarction or rupture, pyelonephritis, bowel obstruction, or aortic dissection

Left lower quadrant (LLQ) pain

Commonly due to diverticulitis, kidney stones, pyelonephritis, ectopic pregnancy, inflammatory bowel disease, inguinal hernia, ovarian cysts, ovarian torsion, pelvic inflammatory disease, psoas abscess, testicular torsion, abdominal aortic aneurysm, irritable bowel syndrome, or small bowel obstructions

Hernias & Eviscerations

A hernia, which is a protrusion of abdominal contents through an opening, can cause extreme pain, incarceration, and potential strangulation. Two types of inguinal hernias exist – direct and indirect. A herniation of abdominal contents outside of the body are referred to as an evisceration.

Direct inguinal hernias, usually in older men, are only covered by external spermatic fascia and go through only the external inguinal ring.  Indirect inguinal hernias protrude through the internal and external inguinal rings and into the scrotum. They are covered by all three spermatic fascial layers: internal, cremasteric, and external.