Protocolo diagnóstico del dolor en fosa ilíaca izquierda

Abstract

Abdominal pain located in the left iliac fossa (LIF) is one of the most frequent reasons for consultation in clinical practice. Its etiology is highly varied, as it includes diseases of gastrointestinal, gynecological, urological, and abdominal wall origin. The most frequent cause of pain in the LIF is acute diverticulitis. A detailed case history and a good physical examination are of enormous value in the diagnosis of this disease and, together with laboratory tests, allow for guiding the diagnosis. However, on occasion, they may need to be supplemented with imaging tests. Computed tomography is the imaging technique of choice for the diagnosis of non-gynecologic causes and ultrasound should be requested as the first line of diagnostic test in gynecologic disease. A plain x-ray has poor cost-effectiveness in this clinical scenario and its use must be limited to select circumstances, such as identification of foreign bodies ingested.