Incorrect. As the pelvic floor is innervated by somatic body wall nerves, pain is typically sharp and well localized. The patient would most likely report pelvic pain. An infection is also unlikely to result in bowel obstruction and inability to defecate.

Incorrect. The appendix is to the right lower quadrant, classically presenting as periumbilical pain that then moves to McBurney's point (1/3rd of the way along an imaginary line from the right anterior superior iliac spine to the umbilicus).

Incorrect. The cecum is to the right side, so a blockage there would cause dilation of the ileum and present with more centralized/right side discomfort.

Correct!  The tenderness in the lower left quadrant is where the sigmoid colon resides. This makes the sigmoid colon high on regional differential diagnosis. The combination of inability to defecate and bloated feeling, with colic pain (often described as 'crampy' pain) are all consistent with some sort of obstructive condition.

Colic pain presents as pain that comes in waves that correlate to the peristaltic contraction waves in the intestines as they pass over/into a region of irritation.  This feels like episodes of cramps occurring from the abdomen.

Incorrect. An obstruction in the transverse colon would cause backpressure tenderness to the right flank (ascending colon).

Incorrect. Most aneurysms, particularly of smaller vessels, are asymptomatic until they start to leak blood. Blood leakage into the peritoneal cavity is likely to cause widespread discomfort rather than localized to a quadrant. Additionally, a leaking aneurysm would not explain the inability to defecate.