Differential Diagnosis for Central Abdominal Pain Radiating to Back and Sides
Single Most Likely Diagnosis
- Pancreatitis: This condition often presents with central abdominal pain that radiates to the back, and the pain can sometimes be referred to the left or right side, depending on the location of the pancreatic inflammation.
Other Likely Diagnoses
- Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause central abdominal pain that may radiate to the back. The pain can be more pronounced on one side, depending on the ulcer's location.
- Gastroesophageal Reflux Disease (GERD): While GERD typically causes heartburn, severe cases can lead to central chest and abdominal pain that may radiate to the back and sides.
- Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant pain that may radiate to the back and, less commonly, to the left side if the inflammation affects nearby structures.
Do Not Miss Diagnoses
- Aortic Dissection: A life-threatening condition where the inner layer of the aorta tears, causing severe, tearing chest and abdominal pain that can radiate to the back and sides. It's crucial to consider this diagnosis due to its high mortality rate if untreated.
- Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can cause severe, sudden abdominal pain that may radiate to the back and sides, accompanied by vaginal bleeding and other symptoms.
- Appendicitis: Although appendicitis typically presents with right lower quadrant pain, atypical presentations can occur, especially if the appendix is located in a retrocecal position, potentially causing central or back pain.
Rare Diagnoses
- Intestinal Obstruction: While more common causes of obstruction like adhesions or hernias typically present with more localized pain and symptoms of obstruction, rare causes can lead to central abdominal pain radiating to the back and sides.
- Mesenteric Ischemia: This condition, involving insufficient blood flow to the intestines, can cause severe, diffuse abdominal pain that may radiate to the back, often accompanied by other symptoms like nausea and vomiting.
- Splenic Infarction: Infarction of the spleen can cause severe left upper quadrant pain that may radiate to the left side of the back, though this is less common than other causes of left-sided abdominal pain.