Differential Diagnosis for Left Upper Quadrant Abdominal Pain
The following is a list of potential diagnoses for left upper quadrant abdominal pain that never goes away, categorized for clarity and emphasis on critical conditions.
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is characterized by stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of the esophagus, causing discomfort. The chronic nature of the pain and its location in the left upper quadrant could be consistent with GERD, especially if the pain is exacerbated by eating or lying down.
Other Likely Diagnoses
- Peptic Ulcer Disease: Ulcers in the stomach or the first part of the small intestine (duodenum) can cause persistent pain in the upper abdomen, which may be localized to the left upper quadrant, depending on the ulcer's location.
- Functional Dyspepsia: This term describes persistent or recurrent upper abdominal pain or discomfort that is not caused by other medical conditions. The pain can be in the left upper quadrant and may be accompanied by bloating, early satiety, or difficulty swallowing.
- Pancreatitis: Although pancreatitis typically causes mid-abdominal pain, it can sometimes be felt in the left upper quadrant, especially if the tail of the pancreas is involved. Chronic pancreatitis could lead to persistent pain.
Do Not Miss Diagnoses
- Splenic Infarction or Rupture: The spleen is located in the left upper quadrant, and conditions affecting it, such as infarction (death of splenic tissue due to lack of blood supply) or rupture, are medical emergencies. These conditions can cause severe, persistent pain and require immediate medical attention.
- Gastric Cancer: Although less common, gastric cancer can present with persistent upper abdominal pain, among other symptoms like weight loss and difficulty swallowing. Early detection is crucial for treatment outcomes.
- Cardiac Ischemia: Sometimes, cardiac conditions like myocardial infarction (heart attack) can present with abdominal pain, including in the left upper quadrant, especially if the pain is referred from the heart due to shared nerve roots.
Rare Diagnoses
- Splenic Artery Aneurysm: A rare condition where the artery supplying blood to the spleen balloons out, which can cause left upper quadrant pain if it ruptures or leaks.
- Left Diaphragmatic Hernia: A rare condition where there is a hole in the diaphragm on the left side, allowing abdominal organs to move into the chest cavity and potentially causing persistent pain.
- Neurogenic Tumors: Tumors arising from the nerves, such as neuroblastomas or schwannomas, can occur in the left upper quadrant and cause persistent pain, although they are rare in this location in adults.