Differential Diagnosis for Abdominal Pain Worse with Deep Breaths
- Single most likely diagnosis
- Pneumonia or lower lobe pneumonia: The worsening of abdominal pain with deep breaths can be indicative of referred pain from the lower lung fields, which can be involved in pneumonia. The diaphragm shares nerve roots with the abdominal cavity, leading to this type of pain referral.
- Other Likely diagnoses
- Gastroesophageal reflux disease (GERD): Although GERD typically presents with heartburn, some patients may experience abdominal pain that worsens with deep breathing due to increased pressure on the stomach and lower esophageal sphincter.
- Peptic ulcer disease: Similar to GERD, peptic ulcers can cause abdominal pain that may worsen with deep breathing due to increased abdominal pressure.
- Costochondritis: Inflammation of the cartilage connecting the ribs to the sternum can cause chest pain that may radiate to the abdomen, worsening with deep breaths.
- Do Not Miss diagnoses
- Pulmonary embolism: Although less common, a pulmonary embolism can cause sudden onset of abdominal pain that worsens with deep breaths due to referred pain from the lungs.
- Pneumoperitoneum: Free air in the abdominal cavity can cause severe abdominal pain that worsens with movement and deep breathing.
- Diaphragmatic rupture: A rupture of the diaphragm can cause abdominal contents to herniate into the thoracic cavity, leading to severe pain that worsens with deep breaths.
- Rare diagnoses
- Diaphragmatic hernia: A congenital or acquired defect in the diaphragm can cause abdominal contents to herniate into the thoracic cavity, leading to abdominal pain that worsens with deep breaths.
- Splenic infarction: A rare condition where the spleen becomes infarcted, potentially causing abdominal pain that worsens with deep breaths due to referred pain.
- Ovarian torsion: Although typically presenting with severe, sudden-onset pelvic pain, ovarian torsion can occasionally cause abdominal pain that worsens with deep breaths.