What causes abdominal pain and flank pain?

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Last updated: February 22, 2025View editorial policy

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Differential Diagnosis for Abdominal Pain and Flank Pain

Single Most Likely Diagnosis

  • Nephrolithiasis (Kidney Stones): This condition is a common cause of abdominal and flank pain, often presenting with severe, colicky pain that radiates from the flank to the groin. The pain is typically accompanied by nausea, vomiting, and sometimes hematuria.

Other Likely Diagnoses

  • Pyelonephritis: An infection of the kidney, which can cause flank pain, abdominal pain, fever, and other urinary symptoms. It's more common in women and can be a complication of untreated urinary tract infections.
  • Appendicitis: Although appendicitis typically presents with right lower quadrant abdominal pain, it can sometimes cause flank or upper abdominal pain, especially if the appendix is retrocecal.
  • Diverticulitis: Inflammation of a diverticulum in the colon, which can cause left lower quadrant abdominal pain but may also radiate to the flank.
  • Gastroenteritis: Inflammation of the stomach and intestines, usually due to infection, which can cause abdominal pain and may radiate to the flanks.

Do Not Miss Diagnoses

  • Abdominal Aortic Aneurysm (AAA): A potentially life-threatening condition where the aorta enlarges, which can cause abdominal and flank pain. It's crucial to diagnose early as rupture can be fatal.
  • Ectopic Pregnancy: A pregnancy that develops outside the uterus, often causing severe abdominal pain and potentially life-threatening if not treated promptly.
  • Pulmonary Embolism: Although primarily a respiratory issue, a large pulmonary embolism can cause referred pain to the abdomen or flanks due to the involvement of the diaphragm.
  • Sickle Cell Crisis: For patients with sickle cell disease, a crisis can cause severe pain episodes, including abdominal and flank pain, due to vaso-occlusion.

Rare Diagnoses

  • Pancreatic Cancer: A rare cause of abdominal and flank pain, often presenting with weight loss, jaundice, and other non-specific symptoms.
  • Renal Cell Carcinoma: A type of kidney cancer that can cause flank pain, hematuria, and a palpable mass, though it's less common than other causes of flank pain.
  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, abdominal pain, and other symptoms due to excessive catecholamine release.
  • Intestinal Obstruction: A blockage of the intestine that can cause severe abdominal pain, vomiting, and constipation, which may radiate to the flanks in some cases.

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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