In evaluating pelvic pain, which GI conditions are commonly considered in the differential?

• A. Appendicitis and diverticulitis
• B. Hepatitis B infection
• C. Gastritis only
• D. Pancreatic cancer

Answer: (A)

When evaluating pelvic pain, consider common acute GI causes that can present with lower abdominal or pelvic-tenderness and mimic gynecologic conditions. Appendicitis and diverticulitis fit this pattern because inflammation in the appendix or in diverticula of the sigmoid colon often produces pain in the lower abdomen that can be perceived in the pelvis, and they are frequent enough to be high on the differential for pelvic or lower abdominal pain in many patients. Appendicitis classically begins with periumbilical pain that migrates to the lower right quadrant, and diverticulitis tends to cause left lower quadrant pain that can localize to the pelvis, sometimes with fever or leukocytosis.

In contrast, conditions like hepatitis B infection typically cause right upper quadrant or systemic symptoms rather than pelvic pain; gastritis usually presents with epigastric discomfort; and pancreatic cancer commonly presents with upper abdominal or back pain in older patients, not pelvis. Therefore, appendicitis and diverticulitis are the most plausible GI diagnoses to consider when the presentation centers on pelvic pain.