Which condition presents with right lower quadrant visceral pain and anorexia?

• A. Acute appendicitis
• B. Crohn's disease
• C. Peptic ulcer disease
• D. Ovarian torsion

Answer: (A)

Pain that begins around the belly button and later localizes to the right lower quadrant, along with loss of appetite, is classic for acute appendicitis. Early visceral abdominal pain comes from the appendix via shared nerves (T10), so the initial discomfort is periumbilical. As the inflammation advances and irritates the parietal peritoneum in the RLQ, the pain becomes sharp and localized there. Anorexia is a common accompanying feature due to GI upset and the body's inflammatory response. While other conditions can involve the RLQ, they don’t typically present with this migratory pattern plus anorexia: peptic ulcer disease is upper abdominal, ovarian torsion presents with sudden severe unilateral pain and gynecologic signs, and Crohn’s disease can cause RLQ pain but usually includes chronicity with diarrhea or weight loss. This combination most strongly points to acute appendicitis.