Differential Diagnosis for Squeezing Pain in the Upper Abdomen
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): The squeezing pain in the upper abdomen that affects breathing could be related to GERD, especially if the pain is worsened by lying down or eating certain foods. The pain can radiate and cause discomfort that might feel like it's affecting breathing due to the proximity of the esophagus to the lungs and diaphragm.
Other Likely Diagnoses
- Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause severe, burning pain in the upper abdomen. While the pain is typically more localized, it can be severe enough to cause discomfort that might feel like it's affecting breathing.
- Gallbladder Disease: Gallstones or cholecystitis can cause sharp, crampy pain in the right upper abdomen that can radiate and cause discomfort that might affect breathing, especially if the pain is severe.
- Pancreatitis: Inflammation of the pancreas can cause severe, persistent pain in the upper abdomen that radiates to the back and can be so severe as to affect breathing.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although the pain is described as being in the upper abdomen, myocardial infarctions can sometimes present with atypical pain, including epigastric discomfort. It's crucial to consider cardiac causes, especially in patients with risk factors.
- Pulmonary Embolism: A blockage in one of the arteries in the lungs can cause sudden, severe chest pain that might be confused with abdominal pain, especially if the embolism is small and affects a lower lobe. The pain can be worsened by deep breathing.
- Aortic Dissection: A tear in the aorta can cause severe, tearing pain that can start in the chest and radiate to the back or abdomen. This is a medical emergency.
Rare Diagnoses
- Splenic Infarction: A blockage in one of the arteries supplying the spleen can cause severe pain in the left upper abdomen that can radiate to the left shoulder.
- Hepatic Artery Aneurysm: A rare condition where an aneurysm forms in the hepatic artery, which can cause severe abdominal pain if it ruptures.
- Diaphragmatic Hernia: A hernia through the diaphragm can cause severe pain and breathing difficulties, especially if the hernia is large or becomes strangulated.