ألم في الربع السفلي الأيمن

Where is my right lower quadrant?

The right lower quadrant is a section of your abdomen (stomach).

Look down at your abdomen, and imagine that the area from the bottom of your ribs down to your pubic hair is divided into four quarters. The quarter on your right side below your belly button is your RLQ.

© بواسطة فريق Blausen.com (2014). "المعرض الطبي لـ Blausen Medical 2014". مجلة ويكي للطب 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436

عرض بحجم أكبر

مناطق الأرباع البطنية

© OpenStax، CC BY 3.0، عبر ويكيميديا كومنز

عرض بحجم أكبر

What organs are in my right lower quadrant?

The right lower quadrant contains organs including:

• الأمعاء الدقيقة (اللفائفي).

• Caecum (the connection between your small and large bowel).

• Appendix.

• Colon (first part of your large bowel).

• Right ureter (at the back of the other organs).

• Right ovary and fallopian tube.

And don't forget the skin, muscles, and nerves of that area.

Common causes of right lower quadrant pain

There are lots of causes of RLQ pain, some of the most common causes are:

• الإمساك.

• التهاب المعدة والأمعاء والتسمم الغذائي.

• متلازمة القولون العصبي (IBS).

• Appendicitis.

• التهاب الرتوج.

• Femoral hernia

• الانتباذ البطاني الرحمي.

• Pelvic inflammatory disease (PID).

These common causes are discussed in detail below.

الإمساك

• الإمساك can cause discomfort anywhere in your abdomen.

• You will normally be aware that you are not opening your bowels as often as usual.

• Your poo will be hard and pellet-like.

التهاب المعدة والأمعاء والتسمم الغذائي

• التهاب المعدة والأمعاء و food poisoning can cause diarrhoea and pain anywhere in the abdomen.

• Pain may ease for a while each time some diarrhoea is passed.

متلازمة القولون العصبي (IBS)

• متلازمة القولون العصبي is very common and causes crampy pains and bloating.

• يأتي ويزول، وقد يصاحبه إسهال و/أو إمساك.

التهاب الزائدة الدودية

• التهاب الزائدة الدودية usually causes pain that starts in the middle of the abdomen then moves to the RLQ over the next few hours.

• Pain tends to be sharper if you cough or move suddenly and may ease a bit if you pull your knees up to your chest.

• If the appendix bursts then pain can be severe and all over your stomach.

التهاب الرتج

• التهاب الرتج usually causes pain in the left lower quadrant (LLQ) but it can be on the right or sometimes can be felt higher up.

• It usually comes with a temperature and a change in bowel habit (opening your bowels more or less often than usual for you).

فتق إربي أو فخذي محتبس

• A right inguinal or فتق فخذي can happen on either side of the abdomen.

• It causes pain in the groin and in the abdomen, usually on the side of the hernia but it may cause pain over the whole area.

• If it happens on the right-hand side, there will be a tender swelling in the right groin.

Causes of right lower quadrant pain in women

ألم الإباضة (ميتelschmerz)

• Mittelschmerz is pain when you release an egg (ovulation), which is usually about halfway between two periods.

• It can be very severe and make you stop what you are doing, but usually eases over several minutes.

• It will only be felt on one side, but can be right or left.

• قد تشعر بألم مشابه في الموضع نفسه على الجانب نفسه أو الجانب الآخر من بطنك في المرحلة نفسها من دورة أخرى.

مرض التهاب الحوض

• مرض التهاب الحوض causes pain that is usually on both sides of the abdomen but can be in the RLQ.

• Pain is usually worse during sex.

• You may also have abnormal bleeding, feel generally unwell and feverish, and have إفرازات مهبلية كريهة الرائحة.

الانتباذ البطاني الرحمي

• الانتباذ البطاني الرحمي can sometimes cause constant lower abdominal pain, although usually it is worse just before, during and for a short while after a period.

• Pain is usually across the lower part of the abdomen but it can be just on the right side.

التواء المبيض

• Twisted ovary (ovarian torsion) usually only develops on the right ovary and causes pain that can be constant or intermittent.

• Symptoms can be similar to appendicitis.

Pregnancy- associated

ألم في الربع السفلي الأيمن أثناء الحمل can be caused by:

• الإجهاض: This usually causes cramping pain, like period pain, over both sides of the lower tummy and is often accompanied by bleeding, which can range from a small amount of dark blood to larger amounts of bright red blood with clots.

• الإمساك: This is very common in pregnancy and gives you crampy lower tummy (lower abdominal) pains accompanied by opening your bowels less often and passing hard, pellet-like stools.

• Pelvic ligament pain: This usually starts at around 14 weeks and is due to the growing womb pulling on the structures which hold it in place. It usually causes a stabbing pain down one or both sides of the tummy.

• Urine infection: This is common in pregnancy. The usual symptoms are of pain when you pass urine and passing urine more often. You may also get tummy pain and a high temperature (fever) and notice blood in your pee.

• الحمل خارج الرحم: You should always see a doctor urgently if you think you might be pregnant and are experiencing right lower quadrant (RLQ) pain. You could have an ectopic pregnancy.

• In later pregnancy pelvic girdle pain, placental abruption and labour can all cause pain in the lower right quadrant. Your midwife will be able to advise you further.

Causes of right lower quadrant pain in men

Any pain coming from the right side of the scrotum can cause pain in the RLQ, but usually the pain in the scrotum will be worse.

التواء الخصية

• التواء الخصية causes severe pain in the scrotum and severe lower quadrant pain, usually on one side.

• الخصية شديدة الحساسية للمس.

• You should seek urgent medical advice.

التهاب البربخ والخصية

• التهاب البربخ والخصية هو التهاب في الخصية و/أو الأنابيب المحيطة بها (البربخ).

• The affected side of the scrotum swells and goes very red and tender.

Other possible causes of right lower quadrant pain

• مرض التهاب الأمعاء (IBD): Types of IBD such as مرض كرون و التهاب القولون التقرحي cause the lining of the gut to become inflamed, and can cause pain in the RLQ.

• حصى الكلى: A stone that passes into the ureter draining urine from your right kidney may cause pain that starts in your right loin and spreads to your groin and RLQ, or into your testicle or penis if you are a man.

• الحزام الناري: A sharp or burning pain may be felt in the stomach before a rash develops.

• تمدد الشريان الأورطي البطني: This can cause pain before it bursts. The pain is usually felt in your back or the side of your stomach but it can occasionally be felt in the right (or left) lower quadrant.

• Muscular pulls and sprains: This can cause pain when you use the pulled or strained muscle.

• سرطان القولون: This can affect any part of the large bowel (colon), but it more commonly affects the last part (descending colon) which is on the left-hand side.

• Referred pain: Pain from your spine or back may be felt around the front.

متى يجب زيارة الطبيب

If you have a pain which doesn't settle, you will probably need to see a health professional to help you figure out the cause.

How is right lower quadrant pain diagnosed?

Your doctor will usually be able to diagnose the cause of your RLQ pain by talking to you and examining you.

They will feel your abdomen in the area you have the pain, but may also need to examine other parts too, such as the rest of your abdomen. You may also be asked to provide a sample of urine, to rule out kidney problems.

قد تحتاج أيضًا إلى إجراء فحوصات دم من أجل:

• Check the function of your liver and الكلى.

• استبعد وجود أي التهاب أو عدوى في جسمك.

• Look for فقر الدم.

• تحقّق من مستوى سكر الدم لديك.

اختبارات إضافية

إذا كان طبيبك لا يزال غير متأكد من سبب الألم، فقد يوصي بإجراء فحوصات إضافية مثل:

• تنظير القولون - this is when a small camera (a scope) is used to check your large bowel.

• التصوير المقطعي المحوسب (CT) - this is used to look for diverticula in the bowel, and also to look at your kidneys.

• فحص بالموجات فوق الصوتية - this is particularly used to look at your ovaries and tubes if you are a woman.

• الأشعة السينية - this is used to look at your gut and kidneys.

• تنظير السيني - this is when a camera is used to check the lower part of your large bowel.

• فحص التصوير بالرنين المغناطيسي (MRI) - this scan allows detailed assessment of abdominal contents.

If it is thought you have appendicitis, an ectopic pregnancy (women) or a torsion of your testicle (testis) - men, you may only have one or two of these tests before having emergency surgery to treat your problem.

Most people will not need all of these tests, and some people may not need any.

Right lower quadrant pain treatment

The treatment for RLQ pain depends on the cause. Treatments for a few of the causes are briefly discussed below.

• الإمساك can be treated with medicines, but often changes to your diet are needed to prevent it happening again.

• التهاب المعدة والأمعاء usually doesn't need any treatment, other than drinking plenty of fluid to compensate for all that is being lost. Occasionally when germs (bacteria) which can be treated with antibiotics are causing the infection, an antibiotic may help.

• التهاب الزائدة الدودية may be treated with an operation (an appendicectomy).

• الحمل خارج الرحم is usually treated by an operation but medical treatment is now more common. This avoids the need for surgery and means the tube is less likely to be permanently damaged.

• الحزام الناري. The pain and rash settle on their own in time, but some people may be advised to take an antiviral tablet to reduce the risk of long-term nerve pain from the shingles.

• التهابات الكلى are treated with antibiotics. Mild infections can be treated with antibiotics at home. If you are very unwell you may need admission to hospital for antibiotics and fluids through a drip (intravenously).

• حصى الكلى. Small kidney stones pass on their own eventually, in which case you will need to drink plenty of fluids and take strong painkillers. Larger kidney stones may need one of a number of procedures done to break them up or remove them altogether.

ما هي التوقعات؟

The outlook depends entirely on the cause of the pain. Some conditions settle very quickly on their own (for example, gastroenteritis), or with the help of antibiotics (for example, a kidney infection).

Others can be cured with surgery, such as appendicitis or torsion of the testicle (testis). Some are long-term conditions, for which there is no cure although there are treatments, such those used for people who have Crohn's disease.

ينبغي أن يكون طبيبك قادرًا على إعطائك فكرة عن التوقعات (مآل المرض) بمجرد اتضاح التشخيص.

الأسئلة الشائعة

Is right lower quadrant pain always serious?

No. Many cases are caused by temporary digestive issues, muscle strain, or mild infections. However, because serious conditions can present in a similar way, it’s important not to ignore persistent or worsening pain.

Can kidney infection cause right lower quadrant pain?

Kidney infections usually cause pain in the back or side, but the pain can spread to the lower abdomen, including the right lower quadrant. However, pain only in the lower right abdomen is less common and usually comes with back or side pain too.