What is the cause of left upper quadrant (LUQ) pain radiating to the back?

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Differential Diagnosis for LUQ Pain Radiating to Back

  • Single most likely diagnosis
    • Peptic ulcer disease: This is a common cause of left upper quadrant (LUQ) pain that can radiate to the back. The pain is often described as burning or gnawing and can be exacerbated by food or improved by antacids.
  • Other Likely diagnoses
    • Gastroesophageal reflux disease (GERD): Similar to peptic ulcer disease, GERD can cause LUQ pain that radiates to the back, especially after eating or at night.
    • Pancreatitis: While pancreatitis typically presents with mid-abdominal pain radiating to the back, it can sometimes be localized to the LUQ, especially if the tail of the pancreas is involved.
    • Splenic infarction or rupture: These conditions can cause severe LUQ pain that radiates to the back, often accompanied by other symptoms such as nausea, vomiting, or fever.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Aortic dissection: This is a life-threatening condition that can cause severe, tearing pain in the chest or abdomen that radiates to the back. Although it is less common, it is crucial to consider in the differential diagnosis.
    • Pulmonary embolism: While typically presenting with respiratory symptoms, a pulmonary embolism can cause chest or abdominal pain that radiates to the back, especially if it is a large or saddle embolism.
    • Ruptured abdominal aortic aneurysm: This is another life-threatening condition that can cause severe abdominal or back pain, often accompanied by hypotension or shock.
  • Rare diagnoses
    • Gastric cancer: Although rare, gastric cancer can cause LUQ pain that radiates to the back, often accompanied by weight loss, nausea, or vomiting.
    • Splenic artery aneurysm: This is a rare condition that can cause LUQ pain that radiates to the back, often accompanied by other symptoms such as nausea or vomiting.
    • Diaphragmatic rupture: This is a rare condition that can cause LUQ pain that radiates to the back, often accompanied by respiratory symptoms or abdominal tenderness.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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