Differential Diagnosis for LUQ Abdominal Pain
The differential diagnosis for left upper quadrant (LUQ) abdominal pain can be categorized into several groups based on the likelihood and potential severity of the conditions.
Single Most Likely Diagnosis
- Peptic ulcer disease: This is often the most common cause of LUQ abdominal pain, especially if the pain is related to eating or has a burning quality. The stomach is located in the LUQ, and ulcers can cause significant pain.
Other Likely Diagnoses
- Gastroesophageal reflux disease (GERD): Similar to peptic ulcer disease, GERD can cause pain in the LUQ due to the reflux of stomach acid into the esophagus.
- Gastritis: Inflammation of the stomach lining can cause LUQ pain, nausea, and vomiting.
- Pancreatitis: While the pancreas is located in the midline and can cause more central abdominal pain, the tail of the pancreas extends into the LUQ, and pancreatitis can cause pain in this area.
- Splenic infarction or rupture: The spleen is located in the LUQ, and conditions affecting it can cause severe pain.
Do Not Miss Diagnoses
- Myocardial infarction: Although myocardial infarction typically presents with chest pain, it can sometimes cause referred pain to the LUQ, especially if the inferior wall of the heart is involved.
- Pneumonia (especially left lower lobe): Lung infections can cause abdominal pain if the diaphragm becomes irritated.
- Diabetic ketoacidosis: This condition can cause severe abdominal pain, including in the LUQ, and is a medical emergency.
- Sickle cell crisis: Individuals with sickle cell disease can experience severe pain episodes, including in the abdomen, due to vaso-occlusive crises.
Rare Diagnoses
- Splenic artery aneurysm: A rare condition that can cause LUQ pain if the aneurysm ruptures.
- Left adrenal gland tumors: Tumors of the left adrenal gland can cause LUQ pain, although this is exceedingly rare.
- Intestinal obstruction or ischemia involving the left colon: While more common causes of abdominal pain are usually considered first, these conditions can cause LUQ pain if the left colon is involved.