LLQ (Left Lower Quadrant): Anatomy, Clinical Relevance, and Common Pathologies

The Left Lower Quadrant (LLQ) of the abdomen is bounded by the left midclavicular line laterally, the transverse umbilical plane superiorly, and the midline medially.

Anatomical Contents

• Descending colon & sigmoid colon
• Left ovary & fallopian tube (female)
• Left ureter (distal)
• Left spermatic cord (male)
• Small intestine loops (ileum)
• Left uterine vessels

Common LLQ Pathologies

• Diverticulitis – #1 cause of LLQ pain in adults; sigmoid inflammation.
• Ovarian cyst rupture / torsion – Sudden sharp pain, adnexal mass.
• Ectopic pregnancy – Rule out in reproductive-age women.
• PID / Salpingitis – Bilateral but often LLQ dominant.
• Ureteral stone – Colicky flank → LLQ radiation.
• Hernia – Inguinal, femoral.
• Colorectal cancer – Obstruction, weight loss, hematochezia.

Diagnostic Approach

History, exam (tenderness, guarding, rebound), labs (CBC, CRP, urinalysis, β-hCG), imaging (CT abdomen/pelvis with contrast preferred; US for gyn).