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Differential Diagnosis for Upper Left Abdominal Pain

Single Most Likely Diagnosis

  • Pancreatitis: The patient's elevated lipase level (73) is a strong indicator of pancreatitis, which is inflammation of the pancreas. The location of the pain (upper left abdomen) also aligns with pancreatic pathology. Semaglutide, a medication used for diabetes and weight management, has been associated with an increased risk of pancreatitis.

Other Likely Diagnoses

  • Gastroesophageal Reflux Disease (GERD): Although the lipase level is elevated, GERD can cause upper abdominal pain and may be exacerbated by or coexist with other conditions.
  • Peptic Ulcer Disease: This condition can cause upper abdominal pain and may be related to the use of certain medications or other factors.
  • Cholecystitis: Inflammation of the gallbladder can cause upper abdominal pain, though the location is more typically right-sided. However, it's essential to consider given the abdominal pain and potential for referred pain.

Do Not Miss Diagnoses

  • Splenic Infarction or Rupture: Given the location of the pain (upper left abdomen), it's crucial to consider splenic pathology, especially if there's a history of trauma or conditions that predispose to splenic issues.
  • Pulmonary Embolism: Although less directly related to the abdominal pain, pulmonary embolism can cause referred pain to the abdomen and is a life-threatening condition that must not be missed.
  • Aortic Dissection: This is a medical emergency that can cause severe abdominal or back pain and must be considered, especially if there are risk factors such as hypertension or aortic aneurysm.

Rare Diagnoses

  • Pancreatic Cancer: While less likely given the acute presentation, pancreatic cancer can cause abdominal pain and elevated pancreatic enzymes. It's essential to consider in the differential, especially if risk factors are present.
  • Splenic Artery Aneurysm: A rare condition that could cause left upper quadrant abdominal pain, especially if it ruptures.
  • Diabetic Ketoacidosis (DKA): Although more commonly associated with hyperglycemia and metabolic acidosis, DKA can cause abdominal pain and should be considered, especially given the patient's use of Semaglutide for diabetes management.

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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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